Report explores structural change in public health services in Milwaukee County

Tax Facts by Wisconsin Policy Forum

As municipal public health agencies in Milwaukee County face ever-changing expectations and a generational test of a global pandemic, an assessment of future challenges suggests it may be appropriate to consider options to improve the structure for delivering these services.

These options include expanding the role of Milwaukee County to complement that of municipal departments, increased collaboration and sharing between existing departments, and consolidation of services.

At the start of the COVID-19 pandemic, an Operations Center was formed comprised of emergency management and public health officials from Milwaukee County and its 11 municipal health departments, as well as health systems, the academia and business. This Unified Emergency Operations Center, or UEOC, has helped coordinate the region’s pandemic response – but has also raised questions about the need for continued coordination and potential structural change across the country. to come up.

To that end, Milwaukee County commissioned the Wisconsin Policy Forum to produce a report examining the current structure of public health services in the county and opportunities for improvement.

Under state law, Milwaukee County is unique among Wisconsin’s 72 counties in that it has responsibility for public health services assigned to municipal governments. Most other counties have a single department housed in the county government. Exceptions include the joint City of Madison-Dane County model; and a two-department model in Racine County in which one department serves the town of Racine and another hosted by the county government serves most other municipalities.

Many public health agencies are also adapting to a new “public health 3.0” model that pushes to go beyond traditional “direct service” activities such as vaccinations, inspections and outbreak response, to a broader range of activities, in collaboration with external stakeholders, to address ‘social determinants of health’ such as housing, transport and access to healthy food.

This transition can be difficult given resource constraints and an affinity for traditional approaches. Any further moves to this model may require increased financial and human resources, as well as greater county and state involvement.

Going forward, options for policymakers to consider include maintaining the status quo, creating a Milwaukee County public health advisory body or a formal supporting role for the county, sharing staff among departments or adopting a two-department consolidation model or a less comprehensive consolidation plan.

Eight public health workers from Milwaukee County’s municipal health departments agreed to be interviewed for the report, and their comments suggest some steps the departments have already taken have laid the groundwork for better coordination. Municipal, county and state authorities, regional health systems and community stakeholders are now free to consider these and other options, to determine which (if any) they would like to explore in more detail. .

This information is provided to members of the Wisconsin Newspaper Association as a service of the Wisconsin Policy Forum, the state’s premier resource for nonpartisan local and state government research and civic education. Learn more at

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