The Library Board met 01/16/2024. One of the information items they received was Library Board trustee training, the focus of which was on Public Health, specifically a concept called Public Health 3.0.
Appleton’s Health Officer Charles Sepers presented to the Library Board. Rather than put together a formal PowerPoint presentation, he provided the board with two handouts, a fact sheet on Foundational Public Health Services and a paper that gave an overview of the Public Health 3.0 concept.
Overall, the presentation only nominally involved the library, but it was still an interesting overview of how the Health Officer views the responsibilities of purpose of the Public Health Department. Additionally, at the tail end of the discussion Health Officer Sepers raised the possibility of the city’s new Community Resources Navigator meeting with homeless clients in the library.
I’ve prepared a transcript of the discussion for download:
Health Officer Sepers told the board that public health did not provide health care. Rather, they were focused on people not getting sick, managing communicable disease scenarios, and ensuring members of the public can access health care. He specifically mentioned the Health Department’s role in managing Environmental Public Health by overseeing licenses for things such as restaurants, food trucks, grocery stores, tattoo parlors, and backyard chickens and bees, the Health Department’s focus on Maternal and Child Health, and the department’s focus on facilitating access/linkages to healthcare through partnerships with local clinics and by working with local organizations to help incoming refugees navigate.
Per Health Officer Sepers, Appleton’s Health Department is a class 3 health department and is required by the DHS 140 statute to operate under a foundational public health services framework. That framework has 8 areas of focus:
- Assessment and Surveillance
- Community Partnership Development
- Equity
- Organizational Competencies
- Policy Development and Support
- Accountability and Performance Management
- Emergency Preparedness and Response
- Communications
Additionally, he noted that the Health Department was guided by the 10 Essential Public Health Services, although he did not include any documents related to that. He noted that that framework was revamped in 2020. The old model had prioritized “research” as its center, but the new model places “equity” as it central priority. Health Officer Sepers explained, “That’s just to highlight that, you know, as we consider when we make the biggest efforts related to moving the needle on population health, the greatest opportunity is focusing on the underserved populations. And so, whether it’s mental health, or if it is diabetes, or anything in between, focusing on—or at least ensuring access to all of the services and supports by all residents is sort of the focus of public health.”
He then talked about the move away from Public Health 2.0 to Public Health 3.0. Under Public Health 2.0, the Health Department was a provider of services, but in Public Health 3.0 it moved away from providing services itself and moved toward “serving as a convener of community partners that are better equipped to provide the sort of clinic services.”
The sort of things that the Health Department during the Covid-era such as managing the mass vaccination clinics was something it did as a “provider of last resort” given the unique circumstances, but it was not within the bounds of what the Public Health Department normally did. Per Health Officer Sepers, “Our governmental infrastructure allows us to provision that sort of care, but that’s not what we do.”
He went on to explain, “moving away from those clinical service more into that that community health strategist role is really the function of what […] the modern Public Health or Public Health 3.0 is.” This was done by looking at “streams of evidence” such as the prevalence of conditions like diabetes in the population and the ratio of doctors and mental health providers in the area and then asking people, “people what it is that that they care about? What is important? How well do we, as a community, address those issues?
The Health Department would then engage in strategic planning by crafting policies and interventions that would enable community stakeholders to address identified health concerns.
One Library Board member asked if the Health Department was “now becoming maybe more integrated in in city decisions where there is a social determinant of health aspect, whether it’s like the housing example or Valley Transit things along those lines?”
Health Officer Sepers responded that a number of years ago the City of Appleton had adopted a “Health In All Policies” ordinance “so by ordinance, we are actually required to consider all of those things as a as a city, when we consider whether it’s, you know, building or if it’s sidewalk construction, all those things are integrated into that that health and all policy framework.”
The board member followed up by mentioning that he had learned that healthcare providers were now required to record the level of healthcare literacy a patient had. [That’s big if true, and one can only hope that this board member wasn’t describing things accurately because if such a scheme is actually happening one can envision it going south pretty quickly.]
The board member in question thought the library might be able to provide patients with health care literacy resources.
Another board member asked if the Public Health Department was already collaborating with the library and what the Public Health Department hoped for in the coming year.
Health Officer Sepers responded that his understanding was that during the Covid-era, the library had been “pretty integral in terms of pushing out information, or at least getting folks routed to the proper phone number.”
He thought that the health care literacy was important for people to be able to advocate for themselves and family members.
He noted that the city had just taken on a Coordinated Entry Specialist position and also a Community Resource Navigator to work with homeless individuals and help them find housing. The Community Resource Navigator was a boots-on-the-ground position that would be making direct contact with clients. They were still fleshing out the work for that position. As they did that, they recognized that homeless people gravitate toward the City Center area including the Transit Center and the library, so they thought that the Community Resource Navigator might be able to meet people in those locations.
[I feel like the presentation would have benefited from more details about what exactly the Public Health Department was planning to do in the library. If it plans to turn the library into a hub to meet with homeless people, that seems like something that warrants a larger discussion that might filter out into the public awareness a little more than a 2-minute mention during a 20-minute presentation at a Library Board meeting.]
View full meeting details and video here: https://cityofappleton.legistar.com/MeetingDetail.aspx?ID=1142254&GUID=B15B2B48-66C1-42C3-975E-23A7919A745E
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