How Orleans Is Rethinking Public Health

ORLEANS – When Hurricane Katrina ravaged New Orleans in 2005, Alex Fitch had to decide whether or not to return there.
 
Fitch, then a college sophomore at Loyola University, came back to her native Cape Cod for a semester after the storm devastated the city. But despite all of the uncertainty that surrounded the idea of life in New Orleans after the hurricane, she made the decision to return.
 
When she got back, she watched first-hand as the city and its residents brought itself back to life. The experience helped steer her toward a career in public health, she said.
 
“It was one of the best decisions I ever made,” she said. “It was so beautiful to witness what happened after and be a part of it.”
 
Having seen what change can come when community members work together, Fitch finds herself almost 20 years later spearheading a re-envisioned health department in Orleans, one with a broader focus on public health and what it means locally post-COVID.
 
Fitch, who first started as the town’s assistant health agent seven years ago before being named health agent in 2021, has been tapped to lead the town’s newly rebranded health and human services department. In addition to focusing on inspections, permits and the work that has historically fallen under the health department’s jurisdiction, the reconceptualized department aims to more readily address other issues that fall under the public health umbrella.
 
“To me, it’s combining human services, health and wellness and really looking at what makes a community happy, healthy and strong. How do you provide everything a community needs to be that?”
 
Fitch and Town Manager Kim Newman had conversations about what a reorganized health department might look like, and Fitch took some time working remotely last summer to research the idea in more detail. That included conversations with health officials in neighboring communities such as Harwich, as well as discussions with health staffers at the state level.
 
Fitch first publicly introduced the new health and human resources department to the select board in November. In her presentation, she highlighted a number of the re-visioned department’s priorities, including providing more early intervention and treatment programs for people struggling with substance abuse, improving community education about the department's offerings, creating community wellness programs that can address issues such as senior isolation, and addressing existing gaps in service for primary and senior health care.
 
The new department will also place an added emphasis on addressing the Lower Cape’s mental health needs, Fitch said. Feedback from a needs assessment conducted last summer showed strong support from residents for additional investment in mental health services locally. The study was paid for through grant money from Orleans and neighboring towns including Harwich, Brewster and Chatham.
 
“With this data, they were really able to give us a picture of what our towns look like now,” she said. “And that provided us the incentive we needed to be able to say "health and human services is the way forward.’”
 
Particularly since the pandemic, town officials have been discussing the need to expand mental health services, but providing adequate access to mental health resources on the Cape has proven difficult.
 
“A big piece of it is a lack of providers,” Fitch said. “I’ve talked to people who have called to get their kids appointments and there’s an 18-month wait list. How do you do that?”
 Helping better connect residents with those services will be one of the department’s top priorities moving forward, Fitch said. The town also learned through the assessment that it needs to do a better job communicating to residents what the department does and what health resources are available.
 
And according to Fitch, people in the community are looking for that direction.
 
“I think the concept of health is changing for people,” she said. “Something positive that came out of the pandemic is, I think people are taking responsibility for their individual health and wellness and are looking for resources.”
 
The department has already begun introducing some new programming, including the weekly winter series “Paving the Path to Wellness.” Provided in collaboration with the Visiting Nurses Association of Cape Cod, the program works to help participants better prioritize their physical and mental wellness. But Fitch said her most immediate priority is rounding out the department’s staffing. That includes the hiring of a new health agent and assistant health agent.
 
The job of reorganizing a department is a big one, and it’s not short of challenges. But Fitch said she’s ready for the opportunity to build something that more wholly addresses the town’s health needs.
 
“It is an amazing opportunity for me personally,” she said.

 Email Ryan Bray at ryan@capecodchronicle.com