 Welcome to Sheboygan County government working for you. My name is Adam Payne County Administrator and co-host of this program with Chairman Tom Wagner and today is a little bit of a bitter sweet taping for us because today will be the final TV8 program with our good friend and Director of the Health and Human Services Department Tom Eggebrecht. Tom welcome. Thanks Adam We were just talking a little bit off the air about the next chapter and I know Tom's looking forward to that But before he leaves us we're gonna learn a little bit about the Health and Human Services Department today It's our largest department one of 19 just under a 34 million dollar budget a lot going on so much important work in that department and Tom please start by Remindersing a little bit. It's been about nine years with the county and you've had a tremendous run Reflect a little bit on what it's been like working for Sheboygan County the past nine years. Sure I've got you know for four decades of Service now in terms of human services ten first ten years was spent in the private agencies in Milwaukee And I've been involved in county government now for 30 years So Sheboygan County for nine years Brown County 11 years before that and Manitowoc County Ten years prior to that and I know Adam that during the time I worked in county government When I had the chance to meet people from Sheboygan They were always down to earth. They were always gracious. They were always friendly So I always had a high regard for the work being done in Sheboygan County Even before I landed here So once the position opened up and I had a chance to apply it piqued my interest I would say through that process having a chance to meet you and Now mayor Mike van der steen who was county board chair at that time Roger Otten who's served on the county board for a long period and serves on our health and human service committee Each of you were on that interview panel and I remember it being I would say More of a conversation than an interview. I left that interview Hoping I'd have the chance to work for Sheboygan County. I remember my wife Reporting to me that she received a phone call from you As as you were preparing to make an offer and she talked about how uplifting that was that has left a very very positive You know impression with her about Sheboygan County about you and about this place and I would say that Having had that opportunity. I've never looked back everyone. I've met everyone. I've worked with has been extremely Gracious friendly. I've enjoyed it. I would say it has been the pinnacle of my career and on many levels My life as well, so I really appreciate being here. Wow. Well, thank you for sharing that and We are so grateful you've been here for the last nine years There's a lot of your peers and staff as you know that are happy for you and Pam But at the same time and the dearly miss you so thank you for sharing that and I'm glad you ended with the county that you felt So good about absolutely wonderful well Focusing on the department in those roles and responsibilities What is the mission of the health and human services department and I know you have a number of staff Working in core program areas give us a little snapshot. Sure. So all counties are responsible by statute for providing safety net services for people experiencing economic hardship health issues Safety issues they might be, you know vulnerable and at risk of abuse and neglect So all counties in the state are responsible for providing health and human service Programs and some counties do that in the form of several separate departments We here in Sheboygan and this is one of the things that has been a blessing for me We have an integrated health and human services department So some counties might have a separate department of public health separate department of community programs Here we're combined and we work under a mission of improving quality of life and self-sufficiency And we do that through several programs as you mentioned and we do that through four separate locations So our main building downtown across from Fountain Park in Sheboygan Offers child protection juvenile justice behavioral health services and our public health operations At the job center on Wilgus Avenue. We offer economic support Programming we have an aging and disability resource center in Sheboygan Falls also known as the ADRC So that Operation provides information and assistance to persons who are aging or have disabilities who might be facing the need for long-term care And we also offer our senior dining program and adult protective services through that location And then lastly child support operations are located in the courthouse annex and child support is directed toward assuring that non-custodial parents Participate in the financial well-being of their children. So there's a lot of work with the courts. So that location is very convenient for them Tom and I we we both now have been around the block for a little while and Chairman Wagner was a school principal teacher. So he worked with a lot of good people good co-workers I've been here now 20 years and I take such pride and Pleasure and work we can with so many good people good-hearted passionate people and Though health and human services may be one of 19 departments when I think about your staff. I Think it's just incredible the work they do that the very challenging and important work that they do and they are very skilled And working in a number of areas please touch on that a little bit talk about your staff and the different skill sets that you Need to have a good team. Absolutely. Yeah, currently we employ a hundred and eighty nine individuals next year We're looking to add a couple more But the number is currently 189 and that staff comes to us from a variety of walks of life So we have people that gravitate to working with us who come from the banking industry from healthcare industry from educational institutions In some cases many cases our staff are fresh out of school And in some cases It's people that have worked for other counties and know a little bit about Sheboygan much like myself who gravitate to work here So we employ as I think about it again pretty diverse group of individuals We've got secretaries account clerks accountants Software professionals business analysts social workers social service aides doctors nurses behavioral health therapists and more So again, it takes all of those people working together to deliver the services that we do I'd like to put in a plug also I Love the fact that we are an employment source for many members of the community And I would encourage anyone who would like to know more about health and human services to make a general inquiry if we can offer information guidance or employment, I would love for us to do so and Folks can make contact with our department by phoning our general number at four five nine three two oh seven We're sending email and care of human dot services at Sheboygan County comm And I'm confident that whoever receives that message would be happy to speak with anyone about employment opportunity well nice overview and as you said just Wonderful caring hard-working people passionate about what they do passionate about making Sheboygan County even a better place and I've just really enjoyed getting to know your staff better over the years wonderful people and and as we talk about a lot in County government on not only good people, but it's about Collaboration it's about partnerships and your department perhaps more so than any has a tremendous number of Partnerships both internally with other departments, but externally with other organizations nonprofit organizations Please touch up on that a little bit and why that's so important to be sure that we're providing good service Yeah, you're right Adam We do employ a number of individuals But the work that we do would not be possible without those partnerships and that exists in two different forms In one a formal contracted relationship So we actually enter into contracts with over 90 separate organizations in the current year And there's about 15 million dollars invested in Those relationships so when you think about our department, we provide some services directly most specifically in the form of behavioral health counseling and in some cases public health nursing But beyond that at our core. We're a case management agency So we assess needs we make arrangement for services We enter into contract for services and those services can include group homes job placement services inpatient Hospitalization crisis response services, etc Then the other type of relationship that we have is with community partners in general outside of contracts But certainly no less important and I would say that the relationships We've had with law enforcement locally have been exceptional I can't say enough about our sheriff's department or local police departments and the collaboration and assistance we receive from them Schools who made mention to Tom and his background in education Schools are such critical partners for us hospitals as I mentioned We work closely with the United Way on a number of initiatives Unbalanced again, we would not be able to accomplish what we have been able to accomplish without those relationships What example I could offer of that collaboration and again viewers might be interested Do an online search for healthy Sheboygan County 2020 and you'll see some information there about the community Agencies that have partnered with us and each other in the interest of assessing community health needs in the interest of developing Health improvement plans, so we work with hospitals agencies school districts United Way in Developing those plans every three years and setting a course that we collaboratively work toward so I think that's an excellent Example of the collaboration that you're describing. No one's paid to do that No, one has to do that, but this community comes together in the interest of doing that. I think it's pretty special I'd also like to make a brief plug when we put our budget together Annually we have a public hearing that's held every June It's important to me and I think it's important to our staff that the work that we do Be responsive to and reflect the interest and the needs of the community. So in June, there's a public hearing opportunity I'd love for us to receive feedback from the public about how we're doing what we should be doing So in the interest of that collaboration not only is it important that we partner with agencies But I think it's also about partnering with the people we're here to serve and so far It's been pretty successful and you've been and your staff have been an outstanding listener You do listen to the community. I think back to the community conversation years ago And hearing about all these programs and services But we didn't have key people to coordinate it and make sure that they were putting people in need and touch with the right Organization you responded to that United Way with path welcome, baby more recent initiatives and the one that really comes to mind to me Tom is the Lakeshore clinic the community clinic that Kristen Blanchard Stearns is the executive director of Wow, I mean, that's just an incredible success story for Sheboyin County And it was our health and human services department even Predating you with and wonder Jim and Dale Hemp and steel who wrote the grant to get that federal Those federal dollars started and now look at the needs that's addressing with dental care and other needs in the community And our department was a part of that so You certainly can take pride in that your staff can take pride in it And I know the county board does because if it wasn't for the county board providing some of those seed dollars some of those resources support Those types of partnerships wouldn't have happened so well done and thank you. Thank Tom. Thank you Adam Welcome Tom. Thanks Tom Sheboyin County's budget. I think your health and human services makes up about 23% of it But not all that is a tax levy and that I think your budget is around 34 million dollars So what percentage or what a dollar amount if you if you know that is is levy from the local property tax Fairs and then what are your other sources and ensure? Yeah, you're right. We get exceptional support again working here. It's been a gracious Giving supportive community. We do receive about 14 million dollars annually in levy support Which is just about 40% of our budget The vast majority of it then comes from State and federal funding sources, so there's different grants. There's different appropriations that we receive and about four million then comes from user fees, so If you need to reside in an assisted living facility through department sponsorship Those individuals would contribute a portion to that cost of care. So again, that's about four million dollars annually So those state and federal sources we actually have 50 different funding sources that come in through our department and they each have different qualification standards different documentation standards different reporting standards and that's where those Secretaries and accountants and business analysts that I referred to earlier Help us keep all of that organized and it's no small challenge. Trust me It's it's a little bit daunting, but it's also a blessing and that we're diversified, you know We have many sources of funds. So as things shift and change in any one front. We have the capacity To think about and pursue correction in other avenues. So it all works together Right as a county board supervisor for the last ten years and then being the chair for less two and a half It always strikes me as Relative especially to the state and federal funding that those are constantly changing all the time that your people have to be you know, whatever was Well, might not be the next year or changes and you're you have to be extremely nimble from what I can tell Yeah, you do have to be nimble which is which is sometimes a challenge You know working within a government process and it's good But it involves vetting it involves decision-making it involves sharing of information at the same time The world is kind of changing very rapidly in the background. And you know as you as you mentioned that Reflect on new staff that have joined us and my advisement to them was it's going to take you two years To feel comfortable with what you're doing and that two years you're going to realize that you will never be comfortable But you just kind of you know acclimate to that kind of Mindset because it's very very real and if we can't change we don't survive Yeah, we think so and that note just to follow up I know we just received a notice from the federal government of a three hundred and set about three and seventy five thousand dollars on a For our treatment courts over I think the next four years. So yes that that would be one of those examples We're very very gratified to receive that Jackie McGlowski our behavioral health manager wrote the application for those funds So I'm very indebted to Jackie and that's one of several that we receive in the course of what we're doing Well, a lot of things change obviously all the time and as we talked about yet to be nimble What do you see for 2019 as far as some of the challenges that are out there for health and human services? Yeah, the challenges for 2019 are not a lot different than what they've been for the last couple of years So we talk about the opioid epidemic. We talk about drug treatment court We've touched on children's mental health those continue to be kind of preeminent concerns if you will Thanks for mentioning the grant. We just received that is going to help us bolster our treatment court efforts One of the things we have planned for the new year is adding an AODA Counselor who we expect to be working more closely with addicted individuals and partnering with our sheriff in the interest of diverting people from incarceration when treatment might be indicated or helping inmates with community re-entry Following incarceration. So it's not enough to simply be released from those correctional settings I think we have to pay attention to treatment needs housing needs employment needs if people are truly going to be successful So we're adding resources on that front. We're also going to add a couple of Therapists to our staff One to work more closely with the schools in the interest of kids who are experiencing crisis who have deep end needs I know it's a challenge for for educational facilities to try to figure out what's going on with kids and Sometimes the answer rests with those kids sometimes with families sometimes with schools sometimes with communities And so we want to get a better handle on that. So we're adding a therapist to help on that front We've pursued a path of becoming better informed about the impact of trauma in people's lives So we're adding a therapist to help kids who've experienced Horrific circumstances early in life heal from those experiences and hopefully get on a better path moving forward We're going to bolster child welfare Services again that area has seen the brunt of the impact from the opioid epidemic So we're adding a supervisor not in the interest of more closely monitoring staff, but hopefully being a More ready resource for staff and guiding them through some of the complexities of cases that we're seeing We're going to be contracting for in-home safety services in our child welfare arena So we've seen an explosion in terms of out-of-home care in recent years We need to do a little bit more to figure out if we can keep kids safe at home in Lou of out-of-home placement and then lastly I know that this has been a couple of years coming But we're going to be able to expand some transportation services to rural areas of our County We applied for grant dollars this year. We received notice Hopefully we're going to get a couple of vans yet at the end of this year that will prepare us for 2019 to offer I guess trips to folks living in rural settings. We've done a pretty good job in terms of medical transports This will bolster that and offer transports if someone needs assistance going to the grocery store or getting to other service facilities We're looking forward to doing that. You talked about our child welfare. I know in our child protect Protective services. There's been just a I think you use the word explosion and then I hear from other counties, too So you want to just talk about that a little more or why that is occurring. Do you sure well as I touched on a Good amount of that relates to the opioid epidemic over the course of the past seven or eight years our Numbers of children and out-of-home care has expanded by over 300 percent so 2010 I think we had 64 children in placement for the year last year 219 in placement for the year and Many of those Circumstances relate to addicted parents or the presence of drugs in homes. I think through the first half of this year Out of the four to five hundred calls that we've received for child protection involvement, we've had 113 children who've been exposed to drugs whose parents are addicted or who themselves Might be addicted at birth It's not uncommon for infants to be born to addicted mothers and to be addicted themselves So 113 out of that group Are facing those issues So the way our child welfare system works calls our screened in terms of is an investigation Warranted and then when investigations are done. There's either Substantiation or closure of case those cases that are substantiated move to ongoing services and out of a hundred and fifty five open cases 100 of those cases are Indexed to drug issues within our system. So when we've got those circumstances in homes Out of home placement for those children becomes kind of an important response That's what's fueled the increase in that out of home care So we've done a couple of things to try to address that number one We have an opioid detox program that we're prioritizing access to For any parents who are willing to change willing to go through treatment willing to go through detoxification But then we've also partnered with the district attorney over the last couple of years To fund a special prosecutor in his office that will help us move toward termination of parental rights When parents aren't able aren't willing aren't prepared to go down that path. So we prefer not to do that I prefer to keep families together. It's traumatic for kids to be separated from families But at the end of the day kids also need Permanency they have a right to a safe home and if natural parents aren't able and willing to go there the district attorney helps us pursue petitions in court for consideration of Terminating those rights which then allows those children to be placed in adoptive homes Okay, and pretty hard to be a parent. It's hard challenging to be a parent anyways, but to be a parent when you're addicted Yeah, it's a pretty tough tough for your children. So it's not just the Addicted person. It's obviously the children who are suffering absolutely. Yeah, it does. We do have a treatment facility And do you want to talk about that a little bit? Sure. So in terms of opioid detox We actually have a protocol within our department of administering a drug called Vivitrol, which helps reduce The cravings if you will Through addiction. So we're helping people through detoxification And we do that through injection of Vivitrol as I mentioned We have a community based residential facility that houses persons during their period of detox And we provide comfort medications to them and then it's typical for individuals to go into a Probably three month or so residential treatment program and we've got contracts with a number of Entities much as I was talking about earlier for provision of that service Following discharge from those facilities those individuals would be enrolled in intensive outpatient programs Through our guidance and we're hoping to bolster that in the new year One of the things we found is that not everyone is ready and prepared to step into treatment So one of the additions we're looking at for the new year also is employing recovery coaches people who themselves have gone through the battle have headed on a path of recovery and might be able to assist us without reach and and support to the Individuals who are considering getting enrolled in the program. Well, thank you Tom. Thank you Tom and thank you Tom Thank you Viewers are following the toms here What a nice overview so much going on at Health and Human Services So many programs and services that your staff administer Many of the challenges are ongoing. Many of them are new and It's just remarkable how many people you help and and what's all in front of us And as you reflect on the last nine years if we just focus on Sheboygan County and some of the key challenges that have come your way and Some of the changes you've made What stands out to you of some areas that you know fill you with pride or gratitude on what you and your team have been able to do Probably first and foremost and this is not one that's particularly Apparent to the community It's nothing that you can look at on a spreadsheet and say oh, yeah I see what that's all about But the one that stands out for me that I think will provide the best return on investment over the long term is our embrace of becoming better trauma informed as an agency so The health care system. I think it's just beginning to understand and grapple with The the health impacts associated with adverse childhood experiences. So when kids have been through trauma Neurologically, they're compromised emotionally They're compromised and we for the past three years have embarked upon an initiative whereby all of our staff are being immersed Immersed in better understanding about trauma and its impacts So I think that'll carry the department and the county well into the future As part of that We we have to be more welcoming as an agency. I love the new addition We've been able to put on our building It is far more welcoming and inviting than it used to be you mentioned the community conversation on mental health 2014 one of the comments was it's difficult to access services. So we established information and assistance staff in our department to help people Accessing service whether it's through our department or elsewhere in the community. I think that's a valuable resource our drug treatment court The partnerships we've had with United Way you touched on it In terms of welcome, baby community partnership for children the PATH initiative We've partnered in the region with other counties to expand mental health services And to develop a child advocacy center and that is specifically Ozaki in Washington counties the last few years We've partnered with to do that. I Think we've improved our business practices over my time here. We've been able to achieve nine consecutive positive budget Outcomes and I'm very proud of that Proud of the work that our staff are doing and overall I think that we just have an excellent team I'm not here to take credit for anything but to give credit To the work that those guys are doing and I think that the county is in great shape and will be for a long time to come I'm so pleased to have been a part of it We're so pleased to we're here as well. It is bittersweet in the last few seconds. We have remaining I just want to again say how much we've appreciated Tom's leadership and the tremendous value Vision work ethic that he brought to Sheboygan County. You have built a stronger team. You have a wonderful team and None of us are irreplaceable, but Tom is going to be tough to replace. We're going to miss you my friend. Thanks Adam So thank you. Pleasure working here. Best wishes Tom on behalf of the county board. Thanks. Thank you for all your work You as well. If you see Tom before he heads out. I think his last day is October 19th That's correct So I'm not quite sure when this will be aired But if you get a chance to reach out to Tom and wish him well, please do Hopefully we'll see him from time to time, but I know he's headed to warmer climate and Please join us next month when we have our finance director Wendy Sharnon here to talk a little bit about our budget process Which is just about wrapped up and looking pretty good a lot of teamwork a lot of hard Work has gone into the budget, but once again We're poised to have a very modest property tax levy increase under 2% and frankly That's pretty remarkable when we get into the programs and services and demands we have so thank you for joining us Thank you. Tom mega-brecht best wishes. See you next month