 Welcome to Sheboygan County government working for you. My name is Adam Payne County Administrator and co-host of this program with Chairman Roger Distruty and as you know every month we strive to focus on a different department and often have a different department head here and today we have Mr. Tom Eggebrecht with us the Director of the Health and Human Services Department. Welcome Tom. Thanks Adam. Let's set the stage by just sharing a little bit about yourself. When were you hired as our director? Just tell us a little bit about yourself. Sure. Well I've been here for not quite five years hired in August of 2009. Worked for Brown County 11 years prior to that and Manitowoc County for 10 years prior to that and worked down in the Milwaukee area for a number of years too. But by far this is the best place to be and I'm so glad to be here. Well we're glad to have you here. I can't believe how the time has flown. I know. 2009. Interesting. Tom is one of 19 department heads that I have the pleasure of working with but works with the largest department budget of a little over 31 million dollars a lot going on in that department and a lot of activity outside the front door right now was from remodeling but before we get into that share a little bit about the different roles and responsibilities of the Health and Human Services Department and the divisions that you will see. Yeah we our work is authorized required under chapter 46 of the state statutes all counties across the state have to provide what I describe is as health and well-being services for county residents and we do that with about a hundred and 78 employees. We have four operating divisions and that includes our public health division our social services division community programs which includes elder services and we offer economic support assistance as well and we do that in actually four separate locations. We have our main offices on a street across from Fountain Park. We have our economic support operation located at the job center which is on Wilgus Road near Taylor Drive. We have an aging and disability resource center which is in Sheboygan Falls on Forest Avenue. We actually have three staff assigned to the Sheboygan area school district. They work out of a school called Tower Academy and they work in the interest of kids that are served in that setting. So while it's not an official work location for us we do have staff assigned there. So all of those locations all of those staff to provide safety net services for the county. When you say safety net services please give our viewers a little bit of a flavor for that. What type of services are provided? Well again at times as persons who are vulnerable subject to neglect or abuse that includes children. We've got elder abuse that occurs as well. It's not uncommon for older persons to be taken advantage of by acquaintances even family members and there's times that we have to go and investigate that. Our juvenile justice services respond to a variety of community needs and typically that's providing community protection as much as it is trying to help kids get on a better path. So when kids get involved in juvenile crime and end up in bad spots we step in and try to correct that path a little bit and then through behavioral health as a lot of folks who are experiencing a lot of difficulties have limited means limited payment resources available to them. So we assess those needs and step in and help when and where we can. Nice nice overview. A lot of people receiving service throughout Sheboygan County and from all walks of life. Correct. Well back to the front door if someone has driven by your main headquarters by across from Fountain Park there in Sheboygan. Certainly they've seen that there's some major construction in play what's happening. Yeah it's kind of interesting I've had some curious questions in recent weeks you know I've had people asking me so is your building being torn down? The answer is no. I say is your building closed? I say answers no. The most interesting one was someone said wow your building really looks better and I'm thinking where did that come from? Because if you drive by it's really in a state of disarray and I'm not sure what they're looking at. I think what they're referring to is that the exterior tiling on the north end of our building has been removed in order to approach this construction project that we're involved in. The south end of the building still has the tile intact so I think they're concluding that the tile on the south end is new and that the north end is going to look like that but in reality we are going through a major construction project we're going to be adding a two-story addition on that building which will improve our lobby improve our entryway and also add some room space inside so if you come to the department right now you can expect to see fencing around the construction zone you can expect to walk through a wooden tunnel that is there to protect visitors from construction debris but with that I'm happy to say that we are open for business. 2.2 million dollar addition, two-story and what were the driving factors for the county board ultimately to authorize that? Well that building that we're in Adam was constructed I think it was in 1921 and it was constructed for application as a medical clinic and I think it served its purpose very well for many many years in a medical clinic you've got different areas of specialty it's not essential that each of those areas works together as one department per se and the county acquired that property I believe in the late 80s in preparation for the creation of our health and human services department. Prior to that time there was a separate department of social services, separate department of community programs and I believe there were two separate public health departments one operated by the county one operated by the city so in 1989 all those departments came together in the form of our comprehensive health and human services department building was acquired for that application it probably could have been maybe should have been modified at that point but it wasn't so today we've got 250 visitors per day that come through those doors we have a lobby area in the main entrance that's able to accommodate six persons at a time which means that all those visitors are cleared to interior spaces in the department where we have four additional reception stations in play so when that happens information and property security is compromised people get cleared into the interior of the building and you don't really have close you know tabs on where they may be at point in time it's not efficient to have five separate receptionists operating in the interest of one department and also consumer privacy is really compromised because when those visitors are cleared to the interior spaces they're typically waiting in what I would describe as hallways or common areas so it's just not a comfortable spot for consumers to be we had a operational study done by virtual crows back in 2006 that recognized all of that virtual crows came in and looked at what we might do to improve efficiencies within our department and one of the recommendations they made was that if ever we could find the means of creating this new addition that we're talking about today we would satisfy all of those concerns we would improve efficiency we would maximize consumer privacy we would eliminate some of those security breaches so it's not a matter of growth that's driving this change it's more about workflow improvement and efficiency improvement as well as just the consumer experience coming into our department it's important to me that when people come to us for assistance and service that they feel comfortable and welcomed when they arrive so we'll be accomplishing all of those things with this project it's time it's a tired building it's served its purpose for a long time and it's going to in the future but it was time for some additional work I know personally coming over to the building from time to time whether it's to see you or for a health and human services committee meeting as you said you walk through that lobby and there are times when people are almost tripping one another because that lobby is so small and then the other more personal experience for those of us who have been in that facility whether it's customers or staff alike some of the bathrooms in that facility are smaller than I think in average person's closet or literally it's difficult to move and being a larger guy it makes me think of the Chris Farley movies where he had some challenges with some small bathrooms but that was clear up clearly an area that we had to improve because you pointed out on a number of occasions that if you have clients there with young children I mean frankly it was difficult for some a mother or father to take their child in a restroom and change a diaper or whatever needs to be done so really nice to see that improvement and then of course the other one I know you're very excited about is you'll finally have a chance to meet with all your staff at the same time yep yeah so as a byproduct where we end up through this project and I appreciate you mentioning the restroom issue we have one accessible restroom in our entire building so we've got you know 178 employees and 250 visitors per day one accessible restroom tucked away in a corner of the third floor so that's been one handicapped accessible one handicapped accessible thank you yeah that's what I mean by there are other ones there's other ones with two foot doors on them right interesting back in the day how two foot door met code and you'd never get away with that now so you'd never get a wheelchair through those doors let alone be able to turn once you're inside so as a byproduct of all these changes we're going through our lobby is going to not accommodate six people it will accommodate 30 we'll have a meeting room on second floor our largest meeting room right now accommodates 40 will accommodate 128 with this new addition we're going to have three accessible restrooms added we'll have centralized reception so we'll go from five reception staff down to three and we can use those employees for other purposes we're going to have some new exam rooms as part of that addition so when we had our TB outbreak last year we had folks with TB walking through the department so they could be seen by public health staff so that's not a great situation for anyone involved visitors staff or others so we'll have two rooms in that new addition for for public health examinations as well as immunizations so when people come in for shots people come in for exams they can do that right off the lobby one of those rooms will have negative pressure handling attached to it so that we don't have you know air exchange through through other than that room and that'll better protect visitors and staff as well and so by and large that's that's what's going to happen in that addition we're also going to be moving our business office from a corner of the second floor down to just off that lobby area there's a lot of folks as they come in to receive services from us that have to check in with our business office and they contribute toward the cost of their care when they can they make payments toward that when they can having that office and a more consumer friendly location is going to be an improvement and then once we get that established those spaces that are being vacated by our business office are going to be rededicated for administrative office purposes mine included right now I'm on the third floor as well back in a corner of third floor it's a great place to be but it's not all that accessible and I think when people call upon me or want to see me I'm kind of hidden away a little bit also our business manager isn't is an opposite corner of the building on second floor and our administrative services supervisor is in the middle of the second floor and quite honestly I do a lot of activity with those individuals and being in three different spots within that building isn't maximum so we're going to repurpose that current business office for administrative office purposes it'll help our workflow but it'll also make the director more accessible to anyone who wants to have contact with them so a lot a lot of activity going on excellent excellent overview a lot going on as you said and final question before I turn it over to Roger when do you anticipate then the construction is going to be complete let's it's going to be a three phase project so so phase number one is is building that new addition that new two-story addition that will include our reception area those exam rooms that I talked about I neglected to mention we also want to create a central intake office when within that new addition and what I mean by that is we've got folks that have difficulty navigating our many many different service areas knowing who to connect with and I think just from a customer service perspective if we could offer assistance there to to visitors right off the lobby that would be value-added so that addition is scheduled for completion in October as things currently stand once our staff move into that new addition and vacate the current lobby that second phase will be reconstruction to create that new billing office that business office that I described and once that's done probably around year-end we can then start considering the repurposing of the business office to remodel for administrative purposes that piece that phase three will be handled by our county staff our building services staff we don't have a schedule developed for that yet but the main renovation should be completed about your end your end yeah time for the new year and maybe a house warming around Christmas hopefully yeah very good thank you Tom mm-hmm Roger Tom good to have you here and great work that your people do and I know many people visitors as well as your staff will appreciate the changes in the health and human services but I also understand the aging and disability Resource Center in Sheboygan Falls will be seeing some improvements as well mm-hmm what is the planning and why why and where that yeah so yeah we have a lot going on and you're right ADRC is going to see some changes as well so much like our main building that current location for the aging and disability Resource Center wasn't designed for that purpose we moved into that building in 2010 I believe it was we had previously been leasing space downtown in what was called the Baxter building which wasn't the most consumer friendly wasn't the best environment and there was a cost the lease cost connected with it so our UW extension offices and vacating the current location in Sheboygan Falls I think they moved out to the UW Sheboygan grounds that created opportunity for us to move our ADRC staff and operations into that building so it's it's much improved office space it's more centrally located so perhaps better for for many residents of the county but it's not optimal in terms of entrance so the main entrance on that building if I'm recalling correctly faces south the parking lot is on the north so when you park to gain access to that building there is no canopy that protects visitors from the elements there is no vestibule once you get inside that protects visitors or staff from the north wind when that door is constantly opening and the reception area there is tucked away into a side room right now you can get there but it's not readily visible when you enter that building so rather than entering through a service door that is not all that welcoming and what had been a back door for that facility we're going to give that a facelift as well so there'll be a new canopy added again to protect people from from the elements as I described there'll be a vestibule added to protect from that north wind and our reception area is going to be moved from the current side office location to close proximity to that entrance so we expect all of that to be an improved consumer experience as well that sounds great and when do you expect that to be completed the timeline on that we expect that will happen this year as well Roger not quite as tight a timeline I can't give you specifics on that Jim to beast of our building services department has been working with the architect and getting final design plans drawn up for that we just got those done we have preliminary estimates on cost but we don't have formal bids yet so once those are received I think that project can get started I would anticipate that might be about year-end as well as long as Jim can handle all of those projects at the same time and some wonderful projects going on but where is the money coming from to pay for that yeah we we have been blessed we have been fortunate through the efforts of our staff and I guess just good fortune in general we've had a number of years in a row of positive budget performance we've outperformed our budget we've hit the end of the year with with fund balance if you will so in both applications with our main building that's about a 2.2 million dollar cost as Adam described we've we've had significant savings in recent years some of which have gone to the county's general fund some of which have been held in fund balance for our department we're able to draw upon those dollars now in lieu of bonding for this project so there's no new costs being added and same thing with the ADRC that's funded through state and federal funds last year we outperformed our budget by about $135,000 and the state has given us permission to carry those funds forward in the interest of this project as well as some furnace replacement at the ADRC so again no new money is going to be involved instead we'll use budget allocations from prior years to get both of these projects done and as anyone knows if they've ever done a remodeling work on their own home or anything there's always some surprises electrical or plumbing behind the the walls have you hit any major problems at all or no um there hadn't been anything you know that has has created big challenges I think our early estimates of cost for the main building project weren't quite where they needed to be and I think once the final study got done and sewer laterals needed to be run out to the street and there was an underground fuel storage tank that needed to be removed and that and that was a bit of a surprise that that wasn't surprise I don't think they were anticipating that and so that that had to be dug out before construction could even be started but with with those things in mind it's been going pretty smoothly and I would say pretty rapidly so I'm pretty pleased with that progress and you mentioned some of the things that building services have done in jim to beast is there any ongoing things that they have to do in the meantime to keep things open for you or is that pretty well handled by the gym I can't say enough about jim to beast the gym has just been so tremendous to work with through this this process and it's not like this is just the last few weeks it was back in 2012 that the east facade of our building needed to be replaced we had a stucco exterior that was kind of deteriorating and so jim planned for that replacement with an eye toward this future addition so basically since 2012 we've been looking at this project he meets with the contractor on a bi-weekly basis he's in contact with us he's been tremendous to work with and again big shout out goes to jim well thank you very much for the work you do John thanks Roger jim to beast if you're not sure well who's jim to beast he's our building services director so he oversees not only this building project but all building projects throughout the county and there's a lot going on this year so he's got his hands full and as you said is doing a great job switching gears back to the services back to where we started a little bit in the very important role and responsibilities of health and human services Tom you and I had the opportunity to attend a meeting at blue harbour I think it's been a couple few months now community conversation about mental health and there's been a lot more discussion and focus on mental health challenges and needs safety net of late not only in this community but nationally please give our viewers a little flavor for well what was that meeting at blue harbour all about who was there and why did it happen yeah estimates Adam suggest we have as many as 23,000 county residents any point in time that would have diagnosable mental health concerns about 5,000 of those individuals would fall in a category of having a serious mental illness we as a county and I'm I'm not happy about this I'm not proud and you know we like to focus on the things that are going well but we outpace state and national averages for suicide we outpace state and national averages for lost productivity due to poor mental health days and we outpace state and national averages for binge drinking so when you put all that together you've got tremendous impact on a community from a cost as well as a social perspective as a department we spend between one and two million dollars annually on emergency mental health care that's hospitalization related to mental health care and that's on behalf of individuals who don't have private insurance don't have medicaid when you start adding those costs into the mix you can understand how significant that is just from a health care perspective but then also when it's not treated when we fail to treat that we end up with very very poor outcomes including suicide we end up with higher levels of incarceration and there's costs connected with all of that so the community came together at that event that you're describing that was organized largely by united way our department mental health america and other agencies to pull together stakeholders in the interest of identifying what we might do to improve upon our health outcomes so the target was 300 attendees i think we ended up with 326 attendees if i'm not mistaken and it was from all walks of of life and and community involvement so we had legislators there we had county board members there we had law enforcement there we had providers there families consumers you name it so it's really quite gratifying in the interest of trying to come up with better recommendations for how we as a community it's not just health and human services it's not just subordinate county it is all players all stakeholders across the community that have a role to play in making improvements and the the day was dedicated to try to come up with those answers and in my tenure and my experience as a county administrator i can't recall experiencing were people from all walks of life and all sorts of different positions roles and responsibilities in this community all came together for a full day to seriously consider the challenges we have here and then start brainstorming a little bit well what can we do better and what are some of the emerging themes that came out of that conference one thing that i think struck me and you and i had a chance to talk about this as well it was pretty amazing when you get 300-plus people in a room all organized around a central theme you would expect that there might be some commonality of knowledge and experience that those people would bring but we found quite the opposite and there were folks sharing tables who are in the service delivery system who had no knowledge of what their counterparts were doing or what the access points were for gaining that that type of care so two main themes for me were a lot of committed people interested in solving this problem but a whole lot of work to be done in terms of how how we can bring that common knowledge up so i think the central themes of that day were we have to improve education we have to improve access and we have to improve service coordination if we're going to make a difference and we we only have a couple of minutes remaining so i know that very shortly you're going to be developing a proposed 2015 budget for the health and human services department any new initiatives that you know were supported by that discussion that you're looking at proposing to the full county board well i think first of all we want to be a good partner i think we want to do this in in collaboration with other community players but with that said we're actively pursuing a concept of helpline and what that means is a a resource that consumers can call we have a crisis line right now we'd like people to have a place they can call before they get to crisis we're working on that we're going to see if we can't establish a central intake position within our department we're also partnering with washington osaki and dodge counties to access some new state mental health funds that the governor approved only available on a regional basis and we're working with those counties in the interest of expanding those services well we talked about a lot in a very little amount of time but wonderful overview tremendous improvements being made to the health and human services department and other buildings but more importantly just a lot of good work being done by tom and his staff to deliver critical programs and services to people in need in this community and as rager said earlier tom i want to thank you for your leadership and the good work that you and your staff do i want to thank you guys for the opportunity it's been great it's always good to have you here and it's always good to have you here on next month we're going to be focusing on another important area in shabuagan county and that's our human resources department gene gallimore hr director will be here and she's going to talk about some new initiatives in hr there's been quite a few changes since act 10 at the state level and on roles and responsibilities policies and procedures focus more on professional development training in the county and just a lot going on so i'm looking forward to gene talking about some of the new initiatives and if you have any suggestions for improvement or if there was something in this program today you heard or you'd like to learn more about don't hesitate to contact your county board supervisor myself or tom agarbrecht and certainly pass on those ideas or where we can provide more information so on behalf of roger distruity and thanks again tom agarbrecht for joining us and myself adam pain thank you for joining us and we'll see you next month