Kirsten Johnson is in her second year as director of the Wisconsin Department of Health Services, and she has a huge amount of responsibility.
The Department of Health Services (DHS) is the second largest government agency, with approximately 6,000 employees. (Only the Department of Corrections, which runs the state prison system, is larger, employing more than 8,000 people.)
DHS’s scope includes maintaining and improving public health in Wisconsin. Regulate hospitals and other medical and therapeutic services through the Quality Assurance Department. It operates the state’s Medicaid services, including BadgerCare Plus. But that’s just scratching the surface.
In his first year on the job, Johnson spent time becoming familiar with the department’s work. She also focused on mental health and resources to address it, which Gov. Tony Evers made a priority when he declared 2023 the “Year of Mental Health.”
The COVID-19 pandemic has put a spotlight on the importance of mental health, not only for the general public but also for healthcare professionals.
“What we went through on the ground, responding to the pandemic and treating people, ultimately collectively going through some trauma and crisis,” Johnson said in an interview with the Wisconsin Examiner last week. Ta.
The current state of health workers is at the top of Mr Johnson’s list of challenges this year. In his State of the State address in January, Evers declared 2024 to be the “Year of the Worker” in Wisconsin, and two weeks ago he announced the creation of a health workforce task force.
Johnson will serve as vice co-chair of the task force, along with Amy Pechacek, who has been nominated to head the Department of Workforce Development (DWD). The agency is headed 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
Mr. Evers named the 25 members of the task force on Tuesday, February 6th. The group includes representatives from the health care industry and professional associations, executives from the state’s major health systems, and officials from medical specialty colleges and technical colleges.
“I sincerely hope that we can galvanize the many experts who serve on the task force to create a collective voice in advocacy for health care workers,” Johnson said.
Johnson said healthcare workers also include those working in public health. She said: “I hope that the task force can use the ideas of health care workers every day to alleviate the burdens that they are experiencing.” [and] Healthcare organizations are going through an experience to build additional trust and confidence that may have been lost due to the pandemic. ”
Rodriguez Said The task force will consider all possible ways to address persistent disparities in the workforce, some of which require enforcement of legislation and others that the executive branch can implement on its own. be.
DHS has the discretion to take certain actions, including: Continued ordering On January 25, the department issued an order giving BadgerCare patients direct access to over-the-counter emergency contraception. “This is something we can do administratively to increase access to reproductive health care for women in Wisconsin.” [and] “This could reduce the burden on health care providers who have to write prescriptions,” Johnson said.
Similarly, DHS will consider whether there are measures that directly address strengthening the health care workforce.
“Are there different types of providers that we can recognize? Is there a certification process that we can put in place?” Johnson asked, speaking hypothetically. “We’re really looking forward to learning from our local partners and providers who are part of the task force. We hope to be able to piece together what we might be able to do internally with our permission.”
Background in community public health
Johnson has been director of the Milwaukee City Health Department since 2021, and previously served as health commissioner for the Washington-Ozaukee County Public Health Department north of Milwaukee for 10 years before becoming DHS Secretary. .
Johnson said her experience in community public health provides useful information for her work at the state health department. In her previous role, she provided direction to DHS and its public health division while addressing local public health needs. Now she says: And how can we best serve the people of Wisconsin?”
The COVID-19 pandemic has been a pivotal experience for the state health department, local health agencies and Johnson himself. During her trip to Milwaukee, she voiced her concerns about a lack of political support from local government officials in her previous job’s response to the pandemic, according to published reports at the time.
In September 2021, as some on the Milwaukee City Council were pressuring the city to renew its citywide mask mandate in the face of a resurgence of the virus, Johnson recommended not to issue power of attorney..
During her DHS confirmation hearing in September, lawmakers asked her opinion on vaccines and mask mandates during the pandemic. She responded that she believes both are important public health measures, but disagrees with the requirements.
“I really thought about masks and mask mandates,” Johnson told the Wisconsin Examiner. She said the mask mandate issued during the first months of the pandemic in 2020 was followed by a “very politicized reaction.” It “has had a negative impact on the conversation about when masks can be used most effectively and when they are helpful and when they are not.”
Johnson said his work as a local health commissioner “allowed me to see firsthand how transmission is occurring.” Normally, it was a close gathering of friends, co-workers or family members where people would have ignored mask mandates, he said.
More subtle messages about masks urged people to think carefully about their risks, advising them to wear masks especially when in close indoor gatherings if they are at high risk of severe illness from the coronavirus. Maybe, she said. On the other hand, she observed, it eventually became clear that masks were not required outdoors.
“Masks are an important tool to protect yourself and protect others if you become infected,” Johnson said. “But it really depends on the situation, so I don’t think it’s something that should be forced.”
New coronavirus infection (COVID-19) enters a new phase
Wisconsin experienced another surge in coronavirus infections in the fall and early winter. Many infected people have home tests that confirm their illness, but individual cases are no longer tracked because they are likely not reported to local public health authorities.
Rather, the spread of the novel coronavirus that causes the disease is primarily measured by the number of people in hospitals and the detection of the virus in wastewater across the state. The latest data from DHS shows that the presence of the virus in wastewater has decreased dramatically in most regions of the state, and hospitalizations are decreasing.
“We’re facing exactly the same situation with this as any other type of respiratory virus that 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 the coronavirus vaccine, which people receive to prevent severe disease and hospitalization, is likely to be given every year, just like the flu, but it was too early to be sure of its seasonal pattern.
Over the past two years, there have been no significant changes in managing the spread of the disease. “We have the same tools that have always been available to us, including the vaccine, staying at home if you have symptoms, and using masks appropriately,” Johnson said. But while public health workers have learned a “huge amount” about the virus, there is still much to learn.
There are still concerns that many people are becoming increasingly reluctant to get vaccinated. He said “political polarization around the coronavirus itself” has led to heightened opposition not just to COVID-19 vaccines, but to older, established vaccines. But it’s not the first time.
“Vaccine hesitancy and the debate around whether vaccines are effective and whether the side effects outweigh the benefits have been around since the beginning,” Johnson said.
The current cycle of mistrust was “largely caused by the pandemic,” Johnson said. “It was scary. People just didn’t know. There was a lot of psychological trauma related to the pandemic…I think all of that scared people.”
But that could change, she added.
“It will take time to rebuild trust and confidence around vaccines,” Mr Johnson said. Although the decline in vaccination rates is across different demographic groups, “we are confident that over time more people will be able to get vaccinated.”
Improving public health
The COVID-19 pandemic has been a challenging time for public health as an institution and as a profession.
“The pandemic has been incredibly difficult in many ways for people who work in public health. They have dedicated their careers to helping people, but they never expected to find themselves on the front lines of a pandemic. I never imagined this – much less a flashpoint. It’s a really politically polarizing issue, but at the end of the day, we’re just trying to save lives,” Johnson said. Ta.
“So there has been some additional psychological damage to people working in public health,” she adds, forcing many leaders in the field into early retirement or career changes. “Because we were all really tired and it was really hard.”
Beneath the ordeal was an experience that gave her hope.
“I think it brought us together in a way that we’ve never seen before,” Johnson said. “And for those of us who have gone through it, it has built relationships, partnerships and community that didn’t exist before. Real, authentic relationships with the school district, city council and county leadership.”
It wasn’t always an easy relationship, she added. “But at the same time, I think in the long run, it’s going to benefit public health as a profession because it’s about the relationships that are formed.”
Johnson said public health infrastructure has “certainly been damaged” both nationally and in Wisconsin during the pandemic. Still, “I think in the long run we’ll get through this with a stronger system.”
She saw that face of hope in the people she worked with at the Milwaukee Health Department.
“The team there is incredibly dedicated and upbeat,” Johnson said. And she is optimistic about the profession as well. “There are a lot of young people who are interested in public health. [enrolled] program in public health and a master’s degree in public health,” Johnson said.
“This is a great profession in that what you do every day matters. And I think that resonates. It resonates for me. My work has always been incredibly purposeful and personal. And I think I have a lot of respect for people who work in public health. They’re just great people who do a really great job and work really hard.”
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