Johnson aims to strengthen state’s health workforce and restore trust in public health

Johnson aims to strengthen state’s health workforce and restore trust in public health

Kirsten Johnson begins her second year as Wisconsin’s health department leader with increasing responsibilities.

The Department of Health Services (DHS) is the second largest administrative department with nearly 6,000 employees. (Only the Department of Corrections, which runs the state prison system, is larger, with more than 8,000 employees.)

The Department of Homeland Security’s responsibilities include maintaining and improving Wisconsin’s public health; regulating hospitals and other health care and treatment services through the Quality Assurance Division; and operating the state’s Medicaid services, including BadgerCare Plus. But this is only superficial.

During Johnson’s first year on the job, she spent time learning more about the department’s work. She also focused on mental health and resources to address the issue, which Gov. Tony Evers made a priority when he declared 2023 the “Year of Mental Health.”

The COVID-19 pandemic has highlighted the importance of mental health – not just for the general public, but also for those working in the healthcare industry.

“Our experiences on the ground dealing with the outbreak and treating people — ultimately we’ve experienced some trauma and crisis together,” Johnson told the Wisconsin Examiner last week.

The state of the health care workforce is at the top of Johnson’s to-do list this year. Evers declared 2024 the “Year of the Worker” in Wisconsin during his State of the State address in January, two weeks after he announced the creation of a health care workforce task force.

Johnson will serve as vice chair of the task force, along with Department of Workforce Development (DWD) Secretary-Designate Amy Pechacek. The agency is led by Lt. Gov. Sara Rodriguez, a registered nurse who worked in hospital emergency rooms and held a series of public health and health policy positions before being elected to the state Legislature.

Bringing together expertise

Evers appointed the 25 task force members on Tuesday, February 6. The group includes representatives from the health care industry and professional associations, executives from major state and university health systems, and technical college officials from health professions disciplines.

“I really hope that we can galvanize many of the experts on the task force and provide a collective voice in advocating for the health care workforce,” Johnson said.

Health care workers include those working in public health, Johnson said. She hopes the task force can draw on the ideas of health care workers every day and “ease the burden health care workers are experiencing.” [and] Healthcare organizations are working to build more trust and credibility that may have been lost due to the pandemic. “

Rodriguez explain The task force will consider a variety of possible ways to address persistent gaps in the workforce — some of which may require legislation and others that can be implemented by the executive branch themselves.

The Department of Homeland Security has the authority to take certain actions, such as standing order The department issued an announcement on Jan. 25 ensuring BadgerCare patients have direct access to over-the-counter emergency contraception. “We can increase access to reproductive health care for Wisconsin women through administrative means [and] This may reduce the prescribing burden on providers,” Johnson said.

Likewise, DHS will examine whether direct steps can be taken to strengthen the health care workforce.

“Can we identify different types of providers? Is there a certification process that can be implemented?” Johnson asked hypothetically. “I’m really interested in learning from the local partners and providers in the working group. I hope we can have a good mix of things going on internally as we get the mandate.”

Local public health context

Johnson, who has served as director of the city of Milwaukee’s health department since 2021 before serving as secretary of Homeland Security, spent 10 years before that as health commissioner for the Washington-Ozaukee Public Health Department in two counties north of Milwaukee.

Johnson said her experience in local public health will help her in her job with the state health department. In her previous role, she sought guidance from the Department of Homeland Security and its public health divisions while addressing local public health needs. Now, she said, “I emphasize, how do we be the best partners, how do we be transparent? How do we best serve Wisconsinites?”

The COVID-19 pandemic has been a critical experience for the state health department, local health agencies and Johnson himself. When she traveled to Milwaukee, she expressed concern that she lacked political support from local government officials in her previous role in responding to the pandemic, according to reports published at the time.

In September 2021, as some on the Milwaukee City Council pressured the city to update citywide mask requirements in the face of a resurgence of the virus, Johnson It is recommended not to issue a power of attorney.

During her DHS confirmation hearing in September, lawmakers asked her about her views on mandatory vaccinations or masks amid the pandemic. She responded that she believed both measures were important public health measures, but that she objected to the requirements.

“I do think a lot about masks and mask mandates,” Johnson told the Wisconsin Examiner. She said mask requirements issued in the early months of the 2020 pandemic were followed by a “really highly political response.” This “hurts the discussion about when masks can be used most successfully…when they are useful and when they are not.”

Johnson said her job as a local health commissioner allows her to “understand first-hand how transmission occurs”: often in close gatherings of friends, co-workers or family, where people may ignore mask requirements.

She said more nuanced messaging about wearing masks might encourage people to think carefully about their risks and advise them to wear them in situations where they are at higher risk of severe illness from the novel coronavirus, especially at indoor gatherings in close quarters. Face mask. On the other hand, she observed, it was eventually clear that masks were not needed outdoors.

“Masks are an important tool to protect yourself and others if you are infected,” Johnson said. “But it’s not something that I think should be mandatory because it really depends on the circumstances.”

DHS CDC visit 185A4210
Wisconsin Department of Health Services (DHS) Secretary-Designate Kirsten Johnson (right) and State Health Officer Paula Tran (center) with Centers for Disease Control and Prevention (CDC) Director Dr. Mandy K. Cohen (left) )chat. On August 16, 2023, Cohen visited the Department of Homeland Security offices in Madison. (Photo courtesy of Department of Homeland Security)

COVID-19 enters new phase

Wisconsin experienced another COVID-19 spike in the fall and early winter. Individual cases are no longer tracked because many infected people confirm their illness through home tests that may not be reported to local public health authorities.

Instead, the spread of the novel coronavirus that causes the disease is measured primarily by the number of people in hospitals and detection of the virus in wastewater across the state. The latest data from the Department of Homeland Security shows a sharp decline in the amount of the virus in wastewater across much of the state, as well as a drop in hospitalizations.

“We’re entering a new territory, and it’s just like any other type of respiratory virus we face every year,” Johnson said. “So we have RSV [respiratory syncytial virus], we had the flu, and now we have the coronavirus. “

Johnson said that, like the flu, people will likely get vaccinated against COVID-19 every year to prevent severe illness and hospitalization, although it’s too early to determine seasonal patterns.

Over the past two years, not much has changed in how we control the spread of the disease. “We have the same tools that we have – the vaccine, staying home when you have symptoms, using masks appropriately,” Johnson said. But while public health providers already know a “huge amount” about the virus, But there’s still a lot to know.

The reluctance of many people to get vaccinated remains a concern. Opposition to both COVID-19 vaccines and older, proven vaccines is fueled by “political polarization around the virus itself,” she said. But this isn’t the first time.

“Vaccine hesitancy and debate around whether the vaccine is effective and whether the side effects outweigh the benefits of the vaccine have been around for as long as they have been available,” Johnson said.

Johnson said the current cycle of distrust was “largely caused by the pandemic”. “It’s scary – people just don’t know. There’s been a lot of mental trauma from this pandemic… I think all of that has had an impact on people who are scared.”

But she added that could change.

“I think we need time to rebuild trust and credibility around the vaccine,” Johnson said. While the decline in vaccination rates affects different demographic groups, “I believe over time we will get more people vaccinated.”

Improve public health level

The COVID-19 pandemic is a test for public health as an institution and as a professional discipline.

“In many ways, this pandemic has been incredibly challenging for those working in public health, who have dedicated their careers to helping people but never thought they would find themselves in the middle of a pandemic. “It’s a really politically divisive issue, but at the end of the day, we just want to save lives,” Johnson said.

“So individuals working in public health are suffering more moral harm in a way,” she added. This has prompted many leaders in the field to retire early or change careers “because we’re all really tired , and it’s really tough.” “.

Deep in the depths of that trial, there were experiences that gave her hope.

“I think it brings us together in a way that we never have before,” Johnson said. “For those of us who lived through it, it created relationships, partnerships and communities that didn’t exist before — real genuine relationships with school districts, city councils and county administrators.”

She added that these relationships are not always easy. “But at the same time, I think it’s going to be good for the public health profession in the long run as it relates to the relationships that are formed.”

Johnson said public health infrastructure across the country and in Wisconsin has “certainly been compromised” during the pandemic. Still, “I think in the long run, I hope we can come out of this with a stronger system.”

She sees that hope in her colleagues at the Milwaukee Health Department.

“The team there is very focused and smart,” Johnson said. She is also optimistic about the career. “There are a lot of young people interested in public health— [enrolled] program in public health and a master’s degree in public health,” Johnson said.

“It’s an amazing profession because what you do every day matters. I think that resonates. It resonates with me – my work has always been very intentional and personal. I I think I have a lot of respect for people who work in public health. They are great people who do a really good job and work really hard.”

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