 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 as you know every month we strive to focus on a different area of responsibility in Sheboygan County. A lot going on here and our largest department is represented today. Today I'm very pleased that we have Tom Agerbrecht our Health and Human Services Director with us and Jody Galloway perhaps a new face to this program but not to Sheboygan County government and I have to look outpatient services supervisor. Yes. Welcome. Thanks Adam. Welcome. Nice to be here. Yeah nice to have you here. This is going to be challenging for our crew going back and forth to two individuals rather than just one but I know they're up for it. Tom let's start with you please please I'll share with our viewers a little bit about the roles and responsibilities of the Health and Human Services Department. Sure Adam. All all counties in Wisconsin are obligated to provide what we could call safety net services. Many states provide those services directly in Wisconsin that's delegated to counties and counties have a lot of latitude under the statutes in terms of how they might organize themselves what services they might offer. Here in Sheboygan County decision was made by the county board then dating back to the late 80s that combined what was previously a Department of Community programs with the Department of Social Services the Department of Public Health and the Department on aging into a combined Health and Human Services Department and I think it's a great constellation. It gives us lots of opportunity to collaborate and work with professionals who otherwise would be in separate you know universes so to speak and it brings them all together so we offer the full gamut of health and human service programming as a county department under that umbrella so at our main building on 8th Street we have child protection juvenile justice child and family resource services behavioral health and public health. We have an aging and disability resource center in Sheboygan Falls located on Forest Avenue job center offers economic support services and application assistance that's located on Wigis Avenue and as of last year the child support department was integrated into our department as well previously another standalone department and that's located in the courthouse annex. And Tom how long has it been now since you've been the director of the Health and Human Services? I've been with the county for seven years. Seven years. Seven years and let me tell you this is one of our shining stars in county government a lot going on in your department the largest department in the county of the 19 departments that we work with. What is your total operating budget and how many employees do you have? Total budget for next year is going to be just over 33 million dollars about 40 percent of that comes from levy balance comes from state and federal as well as private pay sources so we accept insurance payments for certain services in some instances individuals will contribute individually to cost of care so again about 13 million of that is levy the balance of state and federal we've got a workforce of 190 plan for next year. And just an outstanding group of employees I think one of the strengths of our organization as a whole is the collaboration the leadership just the the dedicated workforce that we have and you have some newer managers you mentioned the divisions earlier could you just touch on briefly your leadership team because I know you've got a good one. Sure absolutely so our business and administrative services manager is Shannon Otten and she has been just tremendously helpful to us and she has oversight and involvement with everything that we do she helps put our budget together and she's been just a tremendous asset for me and I think for the rest of our staff as well. Overseeing behavioral health we have a new addition to our management team that's Nick Larkin. Nick came to us just over the course of the summer great great addition he has a nursing background as well as professional counselor background and so much of what we're doing now is focused on behavioral health and so Nick's addition to our team has been tremendous. Tim Gessler oversees economic support services at the job center. Carl and Raditz oversees our public health programming and Scott Shackleford we hired two years ago to oversee child and family services. A lot going on a number of programs and services that we won't have time to touch on today but as you just said a couple of minutes ago behavioral health services have been an area of greater priority and focus of late. Please share with our viewers what's been happening there. Yeah well I quite honestly Adam I pride myself we try to respond to public needs what the community identifies as priorities and consistently I know as I took the position seven years ago there was the work of a ad hoc study committee looking at behavioral health gaps within the county. I walked in to see that report and saw a number of unmet needs so that influenced me every year we have public hearings that identify gaps and needs from a consumer and stakeholder perspective. Consistently we got a lot of requests to expand and improve behavioral health programming our public health division collaborates with the hospitals and other stakeholders to do a community needs assessment every three years consistently behavioral health needs pop up in that and I think a number of the viewers will recall an extensive series the Chevrolet and press ran in recent months about kids in crisis and mental health needs in the schools and elsewhere and there is a lot of data health ranking data if you will that also suggests more to be done so there there is plenty of indicators to suggest we've had to pay attention to that area so over the time of my involvement with the department I think we've addressed quite a few things there's more room to grow but we added psychiatric hours through Jody's assistance we were able to add telehealth capability so we can connect with psychiatrists remotely we've had a case management time we've expanded residential treatment facilities Adam I know you were at a community conversation on mental health two years ago in 2014 at Blue Harbor where a number of stakeholders came together and talked about the need for easier access to services we have a lot of services in the community knowing what they are and how to get to them is not so easy so last year we added an information and assistance position in our department for that specific purpose it's not about helping people gain access to our services alone it's about access to community services in general and I tell you a lot of great feedback from the community about that resource and then just most recently and again part of Jody joining us today is our establishment of a drug and alcohol treatment court here in Sheboygan County which again has been a great great accomplishment and a lot of thanks are owed to Jody for that and that's a perfect transition because I know you and others have been so impressed with Jody's leadership and the work with with the treatment the drug core treatment facility and Jody has just been such an important leader give a nice presentation to the Health and Human Services Committee recently Jody please share a little bit about how long you've been with the county your your role your responsibilities thank you I've been at Sheboygan County for a little over nine years I supervise the outpatient mental health and addiction treatment services at the county and I also oversee our crisis system and over the course of the nine years what's changed from your experience and what have you seen as Tom said what are you hearing what are you responding to as your roles and responsibilities have changed over the years yes I think that there have been long ago there used to be two categories of folks that we would see folks who have addiction and then residents who have mental health diagnoses and issues and more and more over the years we now have people who have both an addiction and a mental health issue and so they they have their duly compromised with both and so that's been that's been a challenge we've also moved more toward evidence-based practice which Tom has been very supportive of and that's been very helpful in attending to some of our more compromised residents who are quite ill so crisis services I think the community hears that from time to time you know what times types of services are being provided for people in need and we have these crisis services what does that mean what does that include and why does that fall under your area of supervision well we are mandated by statute chapter 51 and chapter chapter 34 to provide crisis or emergency services for individuals with mental health concerns and also addiction in the county we have a really excellent system that is comprehensive in my point of view compared to where I've been in in other areas we have a 24-hour crisis line that people can call and we also have a mobile crisis team that the crisis line can dispatch out into the community so that they can meet with individuals who are struggling in person we also have a crisis diversion facility called turning point and that is for individuals who are in crisis but don't need the level of hospitalization per se they can go to this facility in the community for stabilization and then we work with Aurora for our psychiatric hospitalization and detoxification services and I know you can't talk about specific individuals but what would be an example I want to say a common situation but a prevalent situation where you're you're getting a certain type of call or a person in need please give our viewers a sense of what kind of people are reaching out to us for help well we hear from a lot of family members family members of individuals who are struggling with depression and anxiety our two top ones in in the recent years we've also had several cases of young people in their 20s who were experimenting with drugs and alcohol and as a result of that they became psychotic and needed to be hospitalized and stabilized as a result of that and then the opioid addiction and that epidemic has been the source of many many calls to our department for help and if we had someone watching this program over the course of the next month who is a who is a person in need of some help or a family member that has a son or daughter or a friend that needs help and they just don't know where to turn or I've never heard of this opportunity before what would you recommend is there a specific phone number that folks should reach out our specific person or how does that work how does a person take that first step to get the help they need right if they're not in crisis but they're looking for services to be helpful then they can call the county at 459 3155 that's our outpatient services number and there's always someone on call to speak to you they can also walk into our department and meet with someone in person if they'd like to do that and then alternately if they're in crisis the crisis line number is 459 3151 so please repeat both those numbers for me okay the the health and human services outpatient services is 459 3155 and the crisis line number is 459 3151 outstanding thank you for the the high-end overview appreciate it turn it to Tom thank you Adam welcome Jody thank you few minutes ago as mentioned about the alcohol and drug treatment court that was just begotten in Sheboygan County and I know you were very much involved in in that getting going could you tell us a little bit about what led to that decision to go in that direction sure I I wasn't involved in the process at the inception which occurred I believe at the our CJAC committee and really it was in response to the devastation that opioids have had you know across the nation across the state and also here in Sheboygan County and not knowing what to do lots of lives being lost and families being devastated and it was it treatment courts are an innovative approach that have been around about 10 years and we you know wanted to give it a try because they are extremely successful right and I know the purpose of the truth exactly the purpose of the treatment court and exactly how does it work sure the treatment court program seeks to identify felony offenders that their criminal behavior is motivated by their addiction and so instead of them getting going to jail or going to prison after multiple infractions or breaking the law they would get intensive treatment instead because it's a it's sort of a cycle the addiction criminal behavior leads to more of more of the same and those folks just sort of you know go come through the system again and again because they're not receiving the services they need so it provides them with intensive treatment and also very strict community supervision and monitoring to allow them to be able to start their recovery and then get whatever needs met that they need at the time and to become participants in the in the community again not an easy process as I understand it for people to go through it's not necessarily an easy way out but it but the results can be really positive for both the community and the individual from what I understand yes very very positive the the research suggests that treatment courts are very very much worth whatever is spent on them and they actually save dollars for the judicial system I know there's been the contributions of different community members who've been involved in this to get it up and running could you talk about some of the other people were involved absolutely we have a great team which includes a representative from the DA's office from the public defender's office probation in parole sheboygan police department the sheboygan sheriff's department am I forgetting treatment providers and of course our staff from health and human services who are on the team lots of people lots of different departments yes absolutely and what about the judge and the judge yeah thank you he is the he is the the captain of the team absolutely well good in what is the current status now the drug treatment court well we started accepting applications for the program on July 1 of this year and to date we have had 29 applications there are currently nine people enrolled in the program and are actively going to hearings with the judge and doing all of the other expectations that are required and there've been I think 13 people denied because they don't meet criteria for getting in and there's seven or eight that are pending if you're going to come up with something that you feel you've learned now in this process anything that you've learned in this situation I know you're only initially into it but something that kind of stands out to you I think that the collaboration that has gone into this project this endeavor is remarkable and so I've learned I think that sheboygan county is a great place to live where when the need arises people come together and you know everyone puts in there their specialized services and lots of good things can come out of it appreciate all your efforts in that area thank you Adam thanks Tom Jody you made the comment about well there's this criteria that needs to be met in order to get involved and I imagine some people watching this might be thinking well why would some people be included and not others could you get a give an overview of what the criteria we're talking about sure the criteria includes being a Sheboygan county resident the individual has to be suffering from a pretty severe substance use disorder or addiction they have to be at high risk for recidivism and they also cannot be a violent offender or a essentially charges for being a drug dealer or operating a drug house so not just anyone gets the opportunity to go through this and it really is a life-changing experience and opportunity for people who otherwise might be put in a our detention center and not have the benefit of this support to break out of the cycle on that topic too when I tell around the state here are the county board chairs and that talk about it not only is it a victory in human terms it's also which is secondary but it's still there it's a victory in financial terms eventually to the county so it's to me it's a win-win from what I can see right and it's one of the really exciting things sad but exciting at the same time that most folks would think well people want to get into the program because then they won't go to prison for their charges but what we hear the participants saying when they apply to get in is that this program will save their life that otherwise they would be dead right right how many other counties have already implemented a drug treatment court like this I'm uncertain of the number I know of several counties that that have them Waukesha County La Crosse County I thought it was around eight or ten or so yeah I'm not sure how many but we know it's a proven model it works it's a win-win as Tom said yep I want to thank you Jody for your leadership I know between the two of you and all the others involved you got this done and it's a major major opportunity to change lives improve lives in our community it's a win-win and I know chairman Wagner from the beginning has been a cheerleader for seeing this get done and it's so proud that you were able to to do so so thank you both thank you appreciate it Tom I know we don't have a lot of time left but there's a lot of other things going on at the Health and Human Services Department too what are some of the other initiatives that are in play or that you've been a part of sure well you know springboarding from from the drug and alcohol treatment court we we thought of this as a two phase approach when we got up and running phase one was get the court up and running we still have a big gap in terms of detox services for opioid addictions those detox services are not typically available in hospital settings so it falls upon us to come up with a model that can be community based as an alternative to hospitalization I fully anticipate that will be up and running in 2017 and so at that point we're gonna make a much bigger impact in terms of addressing this issue and getting it under control so I'm really looking forward to that as you know Adam through your involvement with United Way we have been strong supporters of this new community partnership for children so I said earlier we do safety net services and it's you know it's frustrating for me because that means everything else has failed by the time people get to us so it's kind of nice to do something on the front end in a preventative mode so we've let some support to United Way and other community partners to do this community partnership for children we're supporting a welcome baby initiative whereby first-time parents are going to have visits in the hospital and connection with services very early on through our public hearings we we heard expressions of concern about the youth moving into the community from larger urban areas partially in response to the job opportunities that exist here but some concerns about acclimation to to the community acclimation to the culture so we've partnered in a pilot program with South High School to offer youth and family mentoring to those kids identified at risk we'll take kind of an experimental approach with this and if we can demonstrate through that initiative that we don't end up with referrals and juvenile justice in other areas it'll be worth expanding that investment down the road I think that's a very exciting opportunity and glad to see you're very much involved with that and the idea of being you'll replicate it if it works yeah that's right and I think so Jody's reference to evidence-based practice let's see what data we get from it and see if it works and if it doesn't let's change things up and try something else I had to get holds great promise so I'm pretty excited about that too and then also you know what what we don't identify with this drug epidemic that's going on in the community is the impact on families as well so we're hoping to put together a coordinated service team to work with our social workers who are working with families who themselves might be drug addicted and see if we can't get integrated support teams connected early on to help battle that return kids to family units and in the interest of psychiatric services as well we're going to be assigning one of our public health nurses to make contact with families who have kids that have been hospitalized under emergency circumstances not to force service on them but to ask if we might be able to offer some assistance the goal would be let's prevent emergency hospitalizations from that point forward so and then the other thing I guess I want to mention on top of it all we are embarking upon what I think is going to be a major and long-term learning initiative better understanding the impact of trauma on health future life if you will there's a lot of strong evidence out there that suggests kids who've been exposed to serious trauma in their early years are going to have very very troubling future outcomes and so our entire workforce now is engaged in this learning initiative so that we can better identify that respond to that and avoid retraumatizing people through the work that we do and and if you step back and you think about providing a child with safety and you remove them from their natural home that seems like a good thing under the statutes it's traumatizing to that kid in reality so we have to be more aware of that more cognizant and respond to that in better ways we had an inaugural community education opportunity on this just back on November 3rd and nearly 500 people in attendance many many school personnel who were extremely excited about the subject matter and wanted more so that to me is going to guide everything that we do for some years to come so we've got plenty in front of us and but we've got good staff to pursue it yeah it's amazing it's amazing what you all do to obviously the chairman and I have a pretty good feel for it but each time we have one of these interviews we we interviewed Joe to check all here recently who as you know has been just a champion for our community and does a lot of challenging work him in his team and a great partner with us great partner going to be retiring the end of this year and one of the questions we asked him and we only have a minute remaining but it has he talked about the challenging work that he does and the very challenging work you do working with you know people in crisis sometimes at the end of their rope I mean you are as you hear this save my life this program this service this connection and I just have Tom and I have nothing but respect for the work that you do and that your staff do every now and then Tom and I'll be on the phone I'll be referring a call to him and I'll get a flavor maybe one day that week or that month of a person in crisis and angry for some reason or another or just hurting for some reason or another and it's a very quick appreciation and reminder to me that many of your staff have these calls every day hourly it's just remarkable so on behalf of the county board and our community thank you for your leadership thank you to your staff and your team for the amazing work you do you you do change lives for the better and we appreciate it thank you for your support appreciate it so if you have any more questions or want to learn more about health and human services roles responsibilities the services that we provide if you know someone that could use some help or need someone to talk to don't hesitate to reach out to Tom Eggebrecht our health and human services director or Jodi Galloway our outpatient services supervisor I was so hoping I didn't need to look at that again or any of their co-workers we're here to help and they do good work so thanks again for joining us thank you next month our health and human services director our human resources director Jean Gallimore is going to be here to talk about some of the challenges we have countywide with filling some of these open positions and getting good people it's one thing to retain when you have wonderful people in place but it's also another to recruit and it's not just Sheboygan County it's countywide we've got about 3,000 job openings in this community and we need good people so please join us next month to learn more about that and until then have a wonderful Thanksgiving a wonderful Christmas holiday and we'll see you in another month or so thanks for joining us