Oneida board approves reclassifications, new positions for Human Service Department

Oneida County’s new Human Service Department is off and running, and last week the Oneida County board of supervisors approved position reclassifications as well as new positions for the agency, which will now provide services in-house that were once provided by the now-defunct Human Service Center.

Human Service Department (HSD) director Mary Rideout requested the positions, none of which is expected to cost taxpayers any money.

In one resolution, county board supervisors reclassified a full-time billing specialist position and a part-time (50 percent) billing clerk position to become finance technician positions within the new department.

A second resolution added a full-time Children’s Long Term Support and Service coordinator; a third resolution added a full-time economic support specialist; and a fourth resolution added a full-time substance use disorder counselor position.

In a memorandum to county board supervisors, HSD officials said the first request — to reclassify a full time billing specialist position to a full-time finance technician position and a part-time billing clerk position to a part-time finance technician position — was necessary because the positions require specific technical knowledge and skill that would justify their placement at the higher levels, a realization officials say they made as they became more familiar with the job duties.

“Insurance, Medicaid and Medicare billing are a very important function within the department that brings in a significant amount of revenue to support our operations,” the board memo stated. “We will be working with staff to make sure we are capturing all available insurance and federal program revenue. Though the two positions, one full time and one part time, were in two different pay categories, the job descriptions for each position were the same.”

That means they basically perform the same function, Rideout told supervisors at Tuesday’s meeting. 

“They do our billing for Medicaid, Medicare and insurance billing for some of the services we provide,” she said. “In my now seven months as interim director and director, I have been evaluating positions with my financial manager and we determined that this is really a critical position within our department. It was in a lower-pay grade at the Human Service Center than the other financial positions and our request to bring that up to the other financial positions is because of the technical knowledge that is needed.”

Insurance billing and Medicaid and Medicare billing is very complicated and having staff do that accurately and efficiently will help maintain or increase revenues, so it is a very critical position, Rideout said. 

No new funding will be necessary, Rideout said, because she believes that, through efficiencies and completing a quality improvement project, the department will be able to generate additional revenue to cover the cost of the reclassifications. 

“That’s not a guarantee by any means,” she told supervisors. “If we don’t realize that, we certainly would be overspent compared to our 2025 budget request, but it’s January and so we really do believe that we will be able to make that.”

New positions

With respect to the Children’s Long Term Support and Service coordinator, the HSD memo to the board observed that Wisconsin’s Children’s Long-Term Support (CLTS) Waiver Program makes Medicaid funding available to support children with substantial limitations due to developmental, physical, or severe emotional disabilities who are living at home or in the community. 

“Funding can be used to support a range of services based on an assessment of the needs of the child and his or her family,” the memo stated. “Eligibility and case management for the CLTS and CCOP (Children’s Community Options Program) are determined by the Support and Service coordinators within the Human Service Department.”

Rideout said the department currently has several staff that do provide that service. 

“This is a service that we provide to Oneida County residents as well as through contract to Vilas and Forest counties,” she told supervisors Tuesday. “It is a service to provide needed services to children with disabilities within our communities. It’s a very beneficial service. It costs the county no money to provide through our contract with the state of Wisconsin, and we are required to provide the service to anybody that applies who is eligible.”

But Rideout said the department needs to watch caseloads to make sure that they have significant staff to serve all the children who apply. 

“And so we are at the point where our caseloads are full with our current case managers,” she said. “So we need to add a position, as I said, there is no tax levy needed. This is fully grant funded.”

According to the memo, the position could possibly be located in Forest County or Vilas County.

Rideout said she would have preferred to have handled Tuesday’s personnel matters through the county’s normal budgeting process but that wasn’t possible this year.

“Because I only became involved directly in the Human Service Center in July, it just took that amount of time for me to figure out exactly what we were providing, how many staff we had, and where we needed additional staffing,” she said. “So we kind of got through the budget process before I could pull that all together. So normally we would be looking at this in the budget process.”

The third position concerns Oneida County’s participation in an income-maintenance consortium, which also includes Marathon, Portage, and Langlade counties.

“We are required by our state contract to maintain system benchmarks to ensure case accuracy and customer satisfaction,” the memo stated. “Consortium-wide we have 53 economic support specialists who assist our residents in their application for FoodShare, Medical Assistance and other economic programs. Even prior to the Public Health Emergency (PHE), which reduced verification requirements for consumers, we struggled to maintain some of these benchmarks, specifically around call center wait times.”

Rideout said the consortium’s operations team, which consists of the consortium manager and supervisors from the four counties, have been working on efficiencies to avoid the need to hire additional staff. 

“Though they have made great progress, it has become clear that due to the increase in case load we need to add staff,” the memo stated. “The consortium is hoping to add three additional positions, one in Oneida, one in Portage and one in Langlade.”

At this week’s county board meeting, Rideout said the county had been involved with the consortium for about 12 years. 

“So the state of Wisconsin decided, well 13 years ago, to change the way that they administered the Food Share and Medicaid program and they went to a county consortium,” she said. “So counties basically had to get together with partners within the state, with other counties to develop consortiums.”

Rideout said the consortium operates a center where people can call in, apply for benefits, report changes, and ask questions, and so staff in Oneida County could be taking phone calls from people in Marathon or Portage.

“If you looked at our data, we continue to have issues with long wait times on our call center and it’s just not acceptable,” she said. “The consortium finally decided that even though we’ve tried many efficiencies, we just really need more staff to do this.”

Again, she said, the position is fully funded.

Finally, the department requested an additional Substance Abuse Counselor (SAC) for the Oneida County OWI Court, approximately 50 percent, and to provide additional substance use counseling to residents of Forest, Oneida and Vilas counties.

“Prior to 2024, Oneida County had a functioning OWI Court,” the HSD memo to the county board stated. “The goal of the OWI Treatment Court is to promote public safety by using an evidence-approach to case management, treatment, and judicial oversight to ensure offenders receive the necessary treatment with a goal to eliminate further impaired driving events.”

OWI Treatment Court offers participants the opportunity to break the cycle of impaired driving, to improve their chance of a sober and healthy life, and to contribute to a safe community, the memo stated

“In 2023, the Human Service Center, who was providing the counseling services for the court, notified Oneida County that it could no longer provide that service,” the memo stated. “A group was then formed to see if we could find a replacement. This group has been meeting monthly to re-establish the court and became a sub-committee of the Criminal Justice Coordinating Committee (CJCC). They have worked with local treatment providers to see if they could support the court.”

Though they have come close, the memo stated, and though treatment providers have worked diligently to meet the need, efforts have been unsuccessful.

“We are therefore requesting to create a position within the Human Service Department to fill this need,” the memo stated. “This position will also be able to serve additional clients within our Outpatient Clinic, meeting an ever increasing need.”

The reclassifications and new positions were all approved.

Richard Moore is the author of “Dark State” and may be reached at richardd3d.substack.com.