##VIDEO ID:DJ15ukSw0sc## all right only two down trees nice oh wow one my dope oh did you have to get the chainsaw out Deb uh I'm a big truck over it I'll just roll right over it over she goes course you have to kind of I can't do that with my Prius I have M worry about driving over little ones and popping a tire and then you drive over it not a ramming speed situation they're all [Music] musical name plates to make certain that was the right person sitting here you are dead white they all look so smiley this morning morning don't feel situated yeah go ahead all right I'm good thank you all right good morning everyone welcome to the um Public Health Public Health and Human Services board for Cook County uh this morning I'd like to call the meeting to order Tuesday November uh 19th 2024 at 8:32 a.m. the um first item on the agenda is our consent agenda and that includes our meeting agenda the minutes um from our last meeting financial report abstract and bills is there any uh Amendment to the agenda or anything a commissioner like to pull off the consent agenda Mr chair make a motion to approve the consent agenda as written thank you commissioner svin we have a motion is there support jny got it thank you support somebody else there is the verbal thank you commissioner white we have motion support any further discussion hearing or seeing none all in favor I I I opposed motion passes unanimously thank you down to our next item is the introduction of new staff we have we have Kristen Peterson and Marissa eckle and I'll first hand it over to Alison McIntyre good morning thank you excited to welcome two new members to our Public Health and Human Services team in the last month I'll let them and their supervisors say a little bit more about themselves but we're really excited to have these position sure so um Kristen started two no I don't know when he started two weeks ago two full weeks ago yeah two full weeks ago we are excited to have her on our team and she is already training she'll be uh working she'll be starting with SNAP training and then a Healthcare Training and yeah she has a full plate um of things to do so we are very excited to have her nice to meet you guys welcome good to meet you thank you for joining the team good morning Commissioners this is um Marissa we're so happy to join have her join us in Children and Family Services as a case manager um Marissa came to us most recently from South Dakota where she did work in child protection that's a state run system there um uh Child Protection so we're excited that she has that kind of background to bring to us although officially she's from Wisconsin so that's right she's like a cousin to the rest of us um and she started last Tuesday so we're happy to have her we just got her settled in her office getting her trained but um yeah she's going to be a wonderful addition to our team her partner works for Arrowhead electric and so he's had a busy some busy days already last week Monday was his first day and then of course today who knows so they have quite the um introduction to Cook County yeah do you want to say anything Marissa about yourself or you're here I mean I think you covered it yeah good to meet you yeah thank for joining the team any questions from any Commissioners all right well enjoy your days and again thank you it's great to meet you good thank you Al and our next item is our staff report and we have dmara Smith um giving our economic assistance Healthcare program update good morning good morning okay so I can't believe it's already been a year since last presentation but I guess time flies Okay so so um economic assistance unit administers financial assistance programs that helps uh low income County residents meet their needs um the basic needs and the programs that we work with are um child care assistance um that assists with the child care cast we have two programs uh for family cash it's a Minesota family investment program and diversion Ary work program uh that help families with lwi income um or families experiencing temporary Financial challenges to pay for food housing utility bills and also provides Employment Services with the goal of reaching Financial stability and exiting the program uh for single adults we have general assistance housing support and um Minesota supplement supplemental assistance those programs help um they provide small cash gr to help people who are age blind or disabled and have low income um we also have emergency assistance program that um helps um families or individuals um secure stable housing um Healthcare programs uh which include medical assistance Medicare Savings Program long long-term care services and um healthare Access program uh we also have a food support program and more um definitely a burial assistance that's another program that's um not listed here we s we serve County residents and uh residents who are in placement out of the county we serve um residents of all ages people with disabilities families and single adults people who are employed or unemployed and all the programs have um income and asset eligibility guidelines and it's different across the different programs so um we will in next slides um there will be some graphs where we can compare the numbers from last 5 years but just kind of like a summary so looking from 2020 to what we know so far in 2024 definitely the case load Peak wasn't that fall winter time 2022 2023 um 2024 case loads numbers are very similar to pre pandemic numbers uh we did um notice increase in child care assistance cases slight increase in family cash cases and slight decrease in um single adult cash cases snap cases are pretty steady over the numbers remain pretty steady over 2024 and they definitely decreased from that Peak numbers in a full winter of 2022 2023 um and definitely significant significant decrease in health care programs so looking at uh so this is a graph representing combin case count and um the blue color represents 2020 2020 numbers the uh and 2024 is the orange line and you can see where um at the beginning of this year uh the case the cases were quite High higher and that that line um went down and eventually crossed with the 2020 numbers and it kind of hovers very close to that so we can see the which month was the peak for cases looks like April of 2023 we had a total of 961 cases and at this point we are down to 7:31 in October Mar andar I know you're going to get into this um as we go program by program but it's fair to say as Healthcare programs are our largest case Lo that that's really driving the decrease in some of those changes in the pandemic related waivers yes so this is definitely the the biggest change is the healthc care um Healthcare cases decreasing as uh during the pandemic uh we did not uh renew any cases uh for healthcare and those um renewal started in July of 2023 so in some of the cases those cases did not have a renewal for 3 years so um when we started doing those renewals the individuals were no longer eligible for health care this is a child care assistance uh program graph it's pretty interesting looking it looks almost like an art project um but yes it's pretty exciting that in 2024 we were able to bring those numbers a little higher um so we can see um and that's the highest in the last 5 years we can see that on average we have nine families that receive child care assistance dougmar do you think it's safe to attribute some of that increased case load to the increase in child care capacity through some of the wage enhancement programs yes I would think uh definitely there is this [Music] um uh this definitely contributed and um we have more spots available for the children to enroll and yes there there's still a need there's still any there's still families who do not have um child care spots but I would say definitely this contributed um the family um cash case load so mfib and DWP programs so that's our Green Line in 2024 the uh number numbers um are a little higher than the last year um and just kind of kind in the middle in a between the Last 5 Years what is that food support program I believe this is a brown the 20124 is the can't see it from here looks reddish I reddish red okay um so um comparing to other years uh the numbers are I would say are pretty steady throughout the 2024 and there are a little higher than pre pandemic but definitely lower than those Peak uh the peak months uh during the 2022 and 2020 23 kind of somewhere in the middle there and the healthcare programs that's where we see the biggest um decrease so the 2024 um that's that brighter Green Line uh we can see that this is at the lowest level um in the last five years kind of meeting the prepandemic Blue Line actually hovering a little bit below uh 2023 numbers that's the darker blue um where we can see the highest amount of cases so um pandemic rules started in March of 2020 and just by chance today today's case numbers not today's October's case numbers for 2024 uh are 559 and the March cases of 2020 are 559 so right there um at the prepandemic numbers and the highest amount of healthcare cases I think that's that 765 in April of 2023 oh no that's the wrong way and this graph represents um total of applications received the 2024 numbers are as of October 1st 2024 so we still anticipate uh that we will receive uh more applications in November and December so I would say uh it's safe to say that probably the numbers for the total for new applications will be close to 2023 we're at92 right now we should definitely get to over 200 so when we're looking at October 2024 we have 213 people who receive Food support we have 13 families who receive cash and food assistance through mfib or DWP ke programs we have nine families who receive child care assistance we have 23 adults who receive um cash assistance through general assistance or MSA we have 972 people who are enrolled in medical assistance and 67 people who receive help with Medicare cast through Medicare Savings program and I have let me just catch up with those slides here but I can give you I think it was kind of interesting to look at the numbers at the snapshot of October 2023 so especially the healthcare program so in October of 2024 we have 972 people receiving Medical assistance in October of 2023 we had 1,350 people receiving medical assistance and [Music] um uh individuals receiving Medicare Savings Program in October of 2023 that was 84 people emergency assistance program that's a one uh one program that we administer it's a um count it's County fund for homeless residents or those facing a housing crisis like eviction or utility disconnect funding is limited um as a c County receive $5,000 allocation for uh families um for the emergency assistance program and $11,000 for single adults in 2024 we um spent our family emergency assistance allocation and that was $5,000 we are expecting a new allocation on January 1st of 2025 and uh with emergency general assistance so that's the program that helps single adults we uh spent $767 out of 1,000 that it's allocated and this allocation renews in July uh we with the emergency assistance payments we were able assist to assist for households um and we issued those payment to secure stable housing year in review it's I was working on that yesterday and it's kind of a eye opener um so we have our team consists of uh four full-time Financial working workers working basically across all the programs uh we have two full-time case AIDS and a supervisor we have 191 cases in Max's system we have 518 cases in Med system and we have 43 uh long-term care cases in the last 12 months so since December of 2023 um until now we [Music] um uh we have four new Financial workers so turn over it's actually very significant um the um the worker who is financial worker that's here the longest um she just had 2year anniversary and then we are looking at a financial worker who started in March June and November uh also our casades are new um and they started in March and September the turnover is due um to many reasons uh we had some internal promotions we have individuals accepting um a um positions with Department of Human Services and then also individuals just looking for something else um so the 2024 definitely was full of training of new employees which I actually enjoy I think this is one of the um best parts of um of my day is to teach new employees about the programs um almost two months ago we also implemented caseworks which is a our new edms system uh so that's again more training and more learning but we are really excited about having this opportunity of using the new Ed edms system it's um case Works definitely is a newer program and offers um uh a lot of improvement in many areas from the work that kads are doing to what Financial workers are doing from scanning to creating forms to transferring the cases program is very intuitive um we are able to do things way quicker um we we are also able to offer a um online portal uh for residents to submit their forms uh we are able to get e e signatures uh definitely we can see um time um time efficiencies uh with with caseworks it's something new it's you know new things um I know we we are excited about it there is a learning curve but after all we are very excited about the program we are also finalizing finalizing the post pandemic Healthcare renewals uh the full process will be completed in June of 2025 we are in our last uh phase of that and with the food support program we uh return to time Li limited recipient policy this policy was unheld during the pandemic years um but we are re relearning what time limited uh recipient polici and implementing that it's basically what it is for individuals who do not uh meet any exemptions there are between 18 and 54 years old they are they don't have any limitations to work uh they don't have miners living in their household then they're only able to receive Food support for three months in threeyear time period uh we are um as we administer the a food support program we um have to meet certain performance goals there are uh put on by federal government it is expected that um certain applications for food support the application that uh screens expedited would that mean means that people um don't have any um any income or any liquid assets to buy food we have to process uh those applications within 24 hours this this would be ideal uh that's the expectation of federal government uh or at least issue a benefit within five business days these numbers represent January through August of 2024 uh we um were able to process to meet that expedited issuance within 24 hours and 66% uh five business days with 88% but um after all we were able to process uh food support applications uh within 30 business days so that's kind of for for all other applications they should be processed within 30 business days and we were able to reach that goal um Minnesota um state of Minesota uh Department of Human Services would like if uh we if we could meet the expedited processing or at least expedited five business days processing in at least 96% so uh we when you take if you would take this split this data by quarters uh we did we did we didn't meet this in the first quarter but we met the 96% in second quarter and the numbers for third quarter are not yet available no wrong way there was a lot of legislative changes um and uh that were um signed in 2023 and they are rolled out throughout the 2023 2024 and will be rolled out in 2025 uh we are uh counties and tribal Nations uh must accept applications for um cash assistance um by phone and video conference this is a big change that uh was not um something that we did before during the pandemic um I would say this was rolled out during the pandemic as all different waivers were were put in place uh we were required to offer this uh to across all the programs the food support and Health Care um remain after the pandemic and we H had to continue to take applications or renewals over the phone and now also that was added to this option was added to um single adult cash programs effective um there is several changes all of these several changes um that are on this page and next page really um uh about improving access uh to residents to to gain access to um benefits um effective January 1st um of this year tribal per capita payments are no longer counted as income for cash assistance programs effective September 1st of 2024 social security income received by individuals at the level of 942 $3 per month is not counted as income anymore for family cash effective October 1st of 2024 the assistant standard for general assistance assistance increase to $350 a month this is a huge change um this benefit uh and this is the first change since 1986 when um and the benefit before was $23 per month uh the increase um like I said just started in October and is now subject to cost of living adjustments so we are anticipating that this amount will slightly increase every year as um as other programs do effective March 1st of 2025 the uh family cash and single adult cash cases will transition to six Monon prospective budgeting and six Monon reviews um right now we do monthly case maintenance on uh on those cases individuals have to complete forms uh monthly and need to provide proof of income monthly we are like if we are processing uh something for December we look at the income they received in October that's how we budget um and that's based on that that's how much benefit They will receive so um starting March 1st we uh we uh will be doing this only once every 6 months this um definitely I'm excited about this change from uh from the worker point of view but also from uh from the recipient point of view and more changes effective January 1st of 2026 the diversionary work program is repelled so right now we have um mhib and DWP program but DWP program is going away and now the only uh family cach program available to um Minnesota families will be M program the big change that happened that was starting in August of uh 2023 uh we started uh processing Healthcare renewals um as experte so Federal Medicaid regulations required that state that states attempt to confirm enroll his eligibility using information in a case File and reliable electronic resources before were sending a paper renewal form and requesting information from thean Ry uh Minnesota was um um not up to date with this process and uh then finally was able to uh start to be in compliance as of August of 2023 so uh again more learning more training for all of all of us uh a big change that [Music] um uh that started January 1st of 2024 it's a continuous eligibility uh for children for medical assistance uh so for CH children who are determined to be eligible for 12 uh for medical assistants who were under the age of 19 um they have continuous eligibility for 12 months uh so their eligibility cannot be closed due to let's say parents being potentially over income uh 20 23 Minnesota legislative session um also extended this to children who are 19 and 20 years old and actually it went further and also extended that for children who are under six so that part is effective January 1 of 2025 so um uh so what that means that basically as of January 1st 2025 children who are under six if they are at any time um if they are determined to be eligible for medical assistance maybe when they are two months old this eligibility will continue until they are six um and then the children between 7 and 20 years old that it's just the 12 months of continuous eligibility um what else the 2020 uh three Minnesota legislative session also amended state law to extend Minnesota care to minnesotans to motans who are undocumented individual this begins January 1st 2025 and Minnesota uh care coverage for people who are undocumented will be state only funded looking ahead we have more training uh redistributing case loads and tasks um and um working with caseworks implementing medical assistance continuously eligibility for children um also learning how to process Minesota care application for and undocumented immigrants and the six months reporting for mfib and ga oh no wrong way okay is there any questions I know there was a lot of information yeah any yeah commissioner um when you were talking about the ex expedited process yes um could you just kind of here you have a child or a family that comes in what are some what are the basic steps that you have to go through so if we receive an application uh we and the individuals are requesting food support we first need to screen the application and uh expedited snap is available for the follow for the following types of the units if the unit if the unit has less than 150 in monthly gross income and 100 or less in liquid assets so whatever they have in cash or any bank accounts or if or otherwise unit whose combined gross income and liquid assets are less than their monthly housing expenses and the housing expenses that we are looking at that's uh utilities and so it's a utility standard and uh rent or mortgage that they pay okay so at that time uh every food support application every food support and cash assistance application requires an interview so we will do an interview we usually do them over the phone but um we also do them in person if that's what someone prefers uh and then we gather verifications and um approve or deny eligibility depending if the family or individuals are eligible with the expedited process if we do have to uh request verification uh that those verifications are postponed so we we are able to issue assistance and then for that month and then uh individuals or families have uh have by the have to provide verification by the end of the month okay Mar could you share a few examples of what mandatory verif ifications are for SNAP or what type of documentation we have to gather to determine eligibility yeah so for in order to issue expedited food support the only verification that we need is proof of identity and then if application is not expedited um then uh we not really all the snap applications require proof of ident the proof of income proof of housing expenses housing expenses that's not a mandatory proof but it could be beneficial as uh it uh if verified will be allow us a deduction so it could uh lower um lower the income and increase the potential benefit also um we have to verify uh student St status for uh individuals who um who attend um institution of higher education um we have to verify medical expenses for uh individuals who are 60 years or older I think and that's all F Support Program does not have asset limits or and that's not required asset verification okay thanks Mr stly thank you chairman well there's certainly a lot of moving Parts here could we get a copy of this yes thank you especially when you have to you know deal with the feds and the state and then you're trying to adjust everything to what the new year is going to bring but I'm going to bring up just some things way off the chart here because we're talking about County Services so in the Star Tribune they had a extensive article about counties who are having to up their um cost for burials and I'm wondering in our County what's the budget have we had a few or how do you see that in the future here because many counties are um dealing with the cost of that yeah so um there's so Allison and Allison uh redo the um burial uh policy maybe two three years ago now and that's when years ago two years ago okay and that's when we increase uh the allowable uh burial assistance amount usually we are required when we working uh with that program if um to technically accept the rate that the um funeral home is requesting so even um even if maybe that amount will be higher than what's Allowed by our policy many times we we have to accept what they they are requesting um I can look up the numbers I believe it's $1,800 for cremation somehow I've got a figure in my mind that it was like $200 toward and this is a few years ago toward a burial yes and I think that's what people are dealing with it's all going up now because of the funeral costs and they're trying to adjust their money at the and what does the money come from you have a little budget Levy dollars that we set aside every year for County paid burial and for 2024 year to date we've expended $3,245 of our total $5,000 budget so we're in good shape for the year um but we would um if ible Grant burial funds even if we didn't have the budget because it's just a requirement okay U for counties and uh that application and eligibility process is a little different from some of the state and federal programs um as we have our own County policy that dgar reference was just updated a couple years ago um we have an appeals process for County burials um with SNAP app and cash programs the state agency and appeals hearing judge is overseeing any um appeal that might be brought forward by a individual or authorized representative or family member so we have an internal process for appeals for County burials but I don't think we're seeing a significant increase in the volume or the amount of burial funds requested through our department thank you any other questions all right thank you very much for the presentation dagara okay you're welcome I hope the next year goes as quickly as this one and yes and hope and hopefully training and turnover is not going to be a good point good point yeah the point of it yeah and dear is very humble and really undersold the fact that she is really carrying multiple case loads right now because of the turnover and the length of training required for some of these programs medical assistance long-term care services in particular it's a a year to a year and a half to even be eligible to take that training so our most senior staff person has been here for two years so we're still in the process of really spreading out that program knowledge across the department so thank you to dear for all that you've done in your first year on the job carrying multiple complex case loads on boarding new staff douara said she enjoys training and mentoring the team that's really evident in her work so thank you dougmar a huge huge benefit for the organization if you enjoy that considering we have that to do right yes we do yeah we have a lot to do but um I guess I've totally spaced it out definitely big kudos to to my team they show up to work every day and they're in front of the lines making sure that our County res residents can access the benefits um that they are eligible for so definitely it's a teamwork this would not happen without them and um it's great it's lots of positive energy positive attitudes and that's how we get through the day thank you thank you the next item on our agenda is the director's report Al as reflected in the updated organizational chart that was included in the meeting materials we have filled two vacancies in the last month you met Kristen this morning who joined us uh just a few weeks ago as an eligibility specialist as dougmar I mentioned she's starting out with healthc care programs um uh Kristen comes to us most recently from norshore Health as a radiology tech so brings that uh background of medical terminology learning a whole new set of acronyms and her new role uh Marissa uh as well joined within the last couple weeks as our children and famili Services case manager that was the new position that the board authorized uh to respond to the increased case load across our child protection services and Kristen was backfilling the vacancy that was created by Ariel's promotion to a social worker We are continuing to recruit for our licensing case manager to backfill ny's position as well as the Children's Mental Health case manager that's been vacant for several months following Marissa's transition to uh waiver case management uh we met with the temporary social work agency last week to discuss next steps for placement of a temporary staff person uh for that Children's Mental Health case management role we again conducted an interview for that position made an offer that offer was declined so continuing to struggle to fill that position we have reposted it and are also moving forward with that temporary Social Work placement we're also connected with a local resident about covering an upcoming Family Leave anticipated within our social services team um that's it for staff updates for the last month uh department-wide big news for us in the last week is that we just uh received notice from the Department of Human Services that we are approved and certified to provide Adult and Children's mobile crisis response services so that has been a significant lift for our team especially while under staffed to uh put together all of the policy documentation and start building out that infrastructure framework for a more formal mobile crisis response Service delivery locally so we do have that approval from the state and our next steps will be to register as a provider with the state to be able to build for those Services we are also deep into the discovery phase of implementation of a new ronic health record with qualifax uh this week we are gathering data and reporting to the credible team for our next phase which will be configuration of the system so pulling together client information for existing clients that are being served through Wilderness outpatient what types of data fields we want to be gathering for the mobile crisis program our staff Information Program information so that when the system is configured it's representative of the services that we provide locally uh we received a notice just yesterday from the Human Services performance management team in a revised uh report that we have met and or exceeded all performance standards for adult protection services and child support services so the the time periods that were measured vary by program area for adult protection this was looking back at July 2023 through June of 2024 for child support that period that was monitored was October 2023 through September 2024 so for Adult Protective Services the standard is um that the percent of adults reported as Mal treatment with initial disposition for response made within five working days so essentially what that means is that at the point that our agency receives a report through Mark which is the Minnesota vulnerable adult um com entry point for people to report concerns regarding a a vulnerable adult or person who may be a vulnerable adult uh that we respond and make a determination within five business days so for 2024 uh our County performance was 96.3 uh out of a total 27 vulnerable adult reports that were received received within that time period so that is 26 out of 27 we responded to within that 5 days which is well over the 90% threshold sent by the state uh well over our regional and state performance Trends so kudos to Martina in particular who's really been carrying that vulnerable adult protection assessment case load uh for some time now within child support we received notice that the performance Improvement plan that we were under previously was closed uh that was within less than a year um and uh if you don't remember when I first reported on that performance Improvement plan we were less than a percentage point off of the threshold again our small case load was really driving that um that coming in just under the performance standard I'm working with Dan to schedule a future presentation to this board so that he can share more information on the services performed by Carlton County Human Services for Cook County residents within the child support program uh we put out a media release earlier in the week maybe it was late last week about a newly established food access Council this is a project being led by our Statewide Health Improvement partnership coordinator Christina Matson as one of the goals identified in our five-year Community Health Improvement plan uh the kickoff meeting is tomorrow November 20th at Cook County higher ed and you can learn more about those efforts in the media release that was uh put out on the 12th and is posted on our website um lastly in the world of Outreach last month I mentioned uh a visit to the library here in Garay to talk more about Outreach and partnership how we can uh support residents who might be accessing services or looking for services at the library uh I was just there with my family earlier in the week and saw that they have a resource wall now in the entryway where they're sharing a lot of program information from our department and other service providers locally and regionally so thank you to the library for your partnership I also want to recognize U Melissa and all the work that she does on getting information out on programs and services uh an effort underway right now is to um increase access to the community resource guide that we maintain and update as a department um Melissa is putting together Flyers with QR codes so that if someone sees that resource guide or a flyer advertising the resource guide out in the community they can access that information in PDF form from our website happy to take any questions about staff or Department updates or otherwise thank you questions I was last month we talked about a training information have you been working on comping I have not been able to prioritize that uh time wise in the last month but uh I should be able to pull that together this week my schedule is a little more open this week and the week ahead but I'll be happy to share that with you and the rest of the board if that's of interest for Broadley and my other question was about our crisis response worker and has there been movement on his ability to move to Cook County still looking for a place to land I think there have been a few options that have fallen through so happy to take any other uh recommendations or resources that people might have for housing and with Allison p on that right now she's aware of another rental in the community that might be opening up so hopeful that that might be a good fit for him and have we dis has there been discussions about how long we're going to let this go about how long it's appropriate for a crisis response worker to be working remotely yeah those are conversations certainly that his supervisor has has had with him in terms of what our expectations would be for for having a person on site there's still quite a bit of work that can be done remotely at this point um certainly by January 1 when we're certified to provide programing uh crisis response services our expectation is that we would have someone here okay on I just wanted to know what the timeline was here how long we're going to let this go thank you thank you commissioner white should should that be a board policy I mean should we have a discussion about this I mean this is Crisis this isn't the normal little crisis excuse me it's not the normal we have no food or I'm homeless crisis but it's crisis and so if the person that is that we have to help the person in crisis isn't around I I I think we should have a discussion about how long that person can I mean I I understand they've got to live somewhere better than their car but um I think we should have a discussion about that at some point and just to be clear commissioner what we are providing mobile crisis services at present and we have coverage for that right now through other members of our Behavioral Health Team primarily through the supervisor is providing mobile crisis response Services while we don't have a person here on site okay and you said last time that there's a training period so even if the person was right here they wouldn't be seeing people they'd be training so that there's that I don't know the length of that right is that right yeah I mean they would likely be shadowing yeah and um going out with the supervisor another more experienced staff person to respond to the few calls that we do receive we anticipate that volume to go up as the program is formalized and we do more Outreach can can you remind us how long the position was open before um Mr ritm believe it was 18 months May of 2023 was when it was vacated by the previous employee and David started in late October early November late October and pro I mean we are looking into temporary services for other positions but this position if vacated might not be a good or could be a good fit or how yeah that's entirely possible that we could work with a temporary social work agency to assist in the placement of a crisis response worker I'll hope for I'll hope for housing but um but yeah it's important to look at our options okay well thank you Allison yeah thank you um any other questions move on uh to our committee report since we have no items for board action first one is the active living streaming committee commissioner white um well commissioner starle will know um better but the little bridge I mean the West End of the county it's connected so uh that was the big top topic of conversation that the opportunities to not walk on the highway on the west end of the county is expanding so that that was a very big thing nice thank you U then we have AOA right um two new board members Linda Bower and Jess Rodney and Jess Rodney is also in charge of the Christmas program reach that you see the little cards on the Christmas trees at the at the banking institutions in the county she has Jess has single-handedly taken care of that program she started it and she's she's done that and the Hub will now be taking over that this is a transition year um Jess has it's time for her to do other things in her life but she's been incredibly passionate about this and the other thing for the um down at the Hub is that they can um had a strong conversation about the uh aeoa buses and the distance that they do not go from Grand marray they don't even make it to Cook County Home Center uh and when they're going to the East and so the if you are a person in the public and you need to have a ride from aeoa with the transit bus please call so it can be documented it doesn't mean the bus will come but uh we need to have numbers to show that it's needed so that's that's important and um just to clarify um Linda and Jess are on the aeoa board or on the oh no no the Cook County Council on Aging board okay that board any news from AOA the board itself no okay um okay thank you um and then Arrowhead Health Alliance commissioner white oh that's me uh they don't meet until uh we met last month and we don't meet again until well into December okay and Arrowhead Regional Corrections commissioner Johnson we had a busy meeting this Friday and I have a couple we have a new director that has been hired Becky has moved up from AJC to be our director I think that's a very good fit um the other discussion item was sublocade I don't know anything about this but it is for people with um opioid addictions and instead of giving daily medications for that this is a once a month shot that they have found works really well and it really helps when somebody is there and then leaves and there's making sure there's no Gap in medication unfortunately this is very expensive and um so St Louis County has um already set aside $100,000 of their opioid funds and for reserve for their residents at nerk to so that this can continue they are asking the rest of the boards the county boards to consider setting aside money instead of increasing our shares the um usage of it that most of the people who are receiving there actually I wrote down here so far this year there's been one from Carlton County and that has cost Carlton County 10,000 there's been one at St Louis County and that has cost 20,000 the fact that the rest of the counties have such small numbers there they are suggesting that they just fill us for that if we have somebody there that needs that service um that's like $2,200 per shot and so St Louis County has already agreed to this it was brought up for discussion of how it should be handled by the board the board decided since this was new to the other four counties really we hadn't discussed it we were to come back to our boards and get approval I didn't get a chance to get this information into the board packet for this meeting here but I can put make sure it gets in for a Tuesday meeting so you can see this but we need to either support having um this available for people if they need it we haven't had many any residents there lately that had would apply to but um the other thing that came came out of this discussion was that um this has been this is not reimbursable through medical assistance um and there had been legislation last year that did not pass to make um reimbursements so that the government would pay for these sorts of needed medications instead of counties we do the same thing with our um law enforcement and so this is a state issue but that it should be one of the legislative uh priorities for next this coming year um so I didn't know if we wanted to come to consensus with this board today about moving forward or should I put this on the agenda for next Tuesday um I know nothing about about it um but I would like to learn more about it um and just when it's more appropriate than other treatment options you're saying like I'm guessing the other ones are daily MH yeah and then this one is monthly and it's for residents of nerd right what is the cost for daily treatment I don't know I didn't get that information no but theyve found according to Becky and um yeah blinking right now um and WALL-E the um they have just found for the cases that they've had so far they are more impressed with this drug than the other drugs that they have been using so I don't know I didn't hadn't even heard about it before Friday's meeting well it's probably I guess yeah we should probably get that on the next agenda um and then hopefully we can get some more info um so um Carlton County is using it well they it they I don't know they didn't um actually the Carlton County Commissioner I didn't get a chance to talk to after that meeting he left right away but um the they just said that that $10,000 they've spent now whether that's come out of um Arc budget anyway or were they submitting that to Carlton County for reimburse that wasn't clear I realized after I finished my notes and I didn't get a chance to talk to the Carlton County Commissioner Friday afternoon um yeah do we have historical data for our community as well like it's been a it's it's not currently in need but uh it could have been a past need do we have any of that or is that something we can do you have that information I did email our County attorney and Alison but you were gone so and I it was my fault for waiting until two days before the meeting to say because I asked for their opinion what is this mhm MH so do you have data on how many residents we've had otherwise I can reach out know I was thinking about that nice annual report you shared earlier in the it was probably in there and I okay well I can dig into that too I I don't have the numbers I I shouldn't guess but I would guess under five a year I think that's a really safe guess um yeah I'm likely less than five mhm well yeah let's put that on um I guess next Tuesday's agenda to discuss more um and we'll see what kind of data we can get there and I'll dive into the arc annual part to see to see what our um what our numbers were in this past year but you even just the one year maybe they have I guess I not even familiar enough with the whole report to know if they've had the trends in there um unless do other Commissioners have other thoughts or how to respond I think we definitely need more information put it okay thank you and please let me know how I can support that if there's any additional data from the Department that I can provide to inform that discussion would perhaps uh Sheriff Eliason have the data on people that we' I think that he'd go to the same sources that we would okay yeah it's I think it's more of the treatment I'm guessing or the the um yeah I have data on probation but I don't have the data I mean right of residents over the last year but I can I can reach out and ask yeah cuz it makes I I can very easily see someone who is you know on probation and outside of nerk how that benefit I mean clearly it would be beneficial while there's still a resident there um yeah may' be I can see where where um where this can get complicated [Music] but um but it sounds very promising if they're like this is the way to go so whatever is going to help our whatever is going to help our our residents I think is um probably what we want to lean into it's my it's my inkling but I would like to know more I guess too um yeah thank you for for bringing that bringing that forward um Child Care Solutions subcommittee commissioner stle thank you we have not met um I would guess we're going to do it in December okay and Community Health Board that's me uh we have our Personnel committee um meeting this Friday um and then I think report reported on the the pass board meeting already um the local mental health advisory Council um I brought brought the wrong month of notes here so I don't know I could reference a notes I wasn't present but I um I know that Melissa uploaded some of the notes already so if you be with me I can pull that up know was a lot of information from our Public Health Team we followed up on the demonstration that we had at our last meeting in October from a organization called credible mind which is a mental health resource platform that is currently in use by counties and health boards throughout the state and Nation it's really a national um [Music] [Applause] platform so there was some discussion and support about exploring that as a a resource for our community and that our our Public Health Team would start seeking out grant funding to offset the expense of that investment um members of our Public Health Team um specifically Andrea and Rosio who are working in prevention shared uh draft Mental Health Resources for Youth and families handout got some feedback from the Council on additional resources to include in that document um we also the or the council also discussed inviting an organization called outfront Minnesota in the future to uh share information specific to the mental health experiences of lgbtq plus community members we had a a youth Mental Health First Aid training at higher ed over the weekend on on Saturday we have two staff uh one from each of the the two schools in town Great Expectations and ISD who have gone through that training to be train the trainer so part of their requirement is to offer that training locally so that was the training that we had on uh Saturday with Sarah from ISD and danne from GES presenting that curriculum I think that that about covers yeah it was a pretty short meeting really okay thank you and then we have um restorative justice commissioner Johnson let's see that group meets tomorrow and tomorrow morning to discuss a Grant application um to hopefully I'm not really sure what this is so I'm going to rely on our County attorney to fill in here and I will do my very best so um in 2023 I think it was the legislature created this new Department of restore of Justice which I think is Under the Umbrella of DHS somehow maybe not Department of Justice Department of yeah what I don't okay not sure corre at any rate what uh it also in the um budget Bill set aside funds to uh fund local restorative justice programs and it has taken the last year and a half to actually get um the grant program going to uh actually fund those local programs and so we are now submitting we Cook County Minnesota restorative justice I'm on the advisory Council so I say we but um are submitting an application for that funding at this point apparently funding can be up to $500,000 per program but but this would be really helpful for the program because we they've recently made a couple of uh really high quality parttime hires um and um that are really really improve the program in my opinion have a lot of um potential to continue to improve the program and serve more folks in the county so um this would continue to fund their positions so that's and the grand application I saw the draft last week it's really well written I think it's written by one of those new part-time employees so uh um I think there are High Hopes uh that we should get some adequate funding because this program has been in place for 5 years now it's not like one it's not a more than five years close to seven years it's um not a brand new program started just to get these funds so great that's very exciting and just a reminder for members on that Council we're meeting here in person at the courthouse tomorrow in the commissioner's room okay uh Council on Aging commissioner white you gave a was there anything more you already gave a report there yeah I gave yeah no but I do have two other things that aren't on the list okay and I would turn them to our administrator inim administrator it was the 911 meeting that was uh led by um Jay um d uh about of course it was radio communications and between which ones are we going to go with he has this $400,000 Grant burning a hole in his pocket not really but it's really going to be beneficial for uh Communications for all of our agencies and organizations but browan if you have any questions he's the man and then the other one was about the um oh Labor Management and we just met and there was a discussion Ron was part of that too so that was about it okay uh well wait we did take a walk through with the uh bkv group at the law enforcement center and they took interior um measurements and they found all the warts and flaws and drips coming through this ceiling no those were taken care of but it was with the maintenance with with um Brook bkv Rowan I forget whom else but people in the know and uh to go forward and they will be doing preliminary drawings um and it was very informational so nice yeah thank you uh emergency preparedness commissioner suvan we did not meet this month but um those of you that were listening to wtip this morning heard uh my Keyport on there talking about this is winter weather Awareness Week um it should be snowing not raining um but he um just reminded our community about how to get prepared for uh extreme weather in the winter and um also he mentioned that they're continuing to work on our Hazard mitigation plan they're compiling all the input that has been received from stakeholders and are kind of comparing the input with the current plan to decide what needs to be um removed or what needs to be added so we'll have more of an update next month thank you Healthcare planning committee commissioner stle we did not meet okay then n anything there one of the best winter preparations you can make us have good tires Mr Keyport mentioned that time persons um so at um ni we've been discussing about prioritizing and developing um and advocacy uh strategies and um the topic right now the heading is mental health and underneath all of that are the different areas that um that we're concerned about rural Care Health also um hospitals in various parts of United States are having to close due to budget restrictions and um nursing homes that are attached to that then are gone too so it's a huge difficulty within the United States because I hear from people all over the country at these meetings and then caregivers you know for them to have um a good wage and maybe a retirement too so that's a discussion that will obviously be ongoing within um the greater uh group that um I'm concerned with and then when you get all of these put together then we need the federal and state support in order to um identify the priorities but the good thing is between now and when no meets the 1st of March we have AMC and so when I go there I'll hear a greater um broader um concern about what's going on and with all of us too if you have concerns or topics that you think I should know about and talk to the folks in this country then let me know so we have some time to do this um we do not have a meeting in December because they have a western gathering in California but because I'm we're going to na that'll be my uh chance to like I say put stuff together to prioritize some of the areas that we feel are important from Minnesota and you know it goes all around the country all 3,45 counties we all have the same concerns so appreciate if you have any thoughts too thank you thank you uh Northeast Minnesota office at job training commissioner Johnson well I don't have anything to report there but I do have something to report about the community center and extension please if I could do that cuz realize what was discussed there you know really fits well with what's happening with this group of people here um as far as health and wellness um so Community Center I want to report the skateboard park got resurfaced it was done we paid for the materials Chris gild Shout out to Chris he donated his labor so great kids are loving it I hear it's wonderful the community Orchard was very successful this year um four bags of apples went to the Food Shelf um the downfall went to Farmers one bag apples went to the culinary art programs they also went to the schools for their school lunch programs um there were many activities the teachers were doing not only in the orchard itself but in the classroom so um they and they are looking to kind of organize their volunteer um list for next year so that's working the farmer Market what had their banner year that is a very successful program and talking about snap um you know Sarah got that snap program initiated up there so $10 of snap equals $30 in buying power and that was very successful there's also the power of produce which has no income limits which is for people age 65 Plus or kids 4 to 12 and I wrote down there were 120 kids that participated this last summer on that um that was very popular and then Wick and I apologize I didn't take really great notes but you can read the the minutes I what the exact details are talk to Sarah but um $1,580 was spent in these programs alone that's not just other people buying things there so this was very beneficial to our community so when we're talking about um in our budget for next year we do have a part-time assistant in that budget um if this program keeps growing the way we expect it to grow because Anna's already got ideas for next year of how to expand on that just this is a heavily used facility in our community um the log cabin is book solid Monday through Thursday youth volunteers we had 17 youth volunteers this year 12 of them volunteered over 500 hours that's for ages 11 through 14 where they volunteer to earn money so they maybe can get their ski pass or take music lessons or whatever they're working towards so that was pretty great that we had 17 involved in that program and the other really good news that I heard was well hopefully we have ice this year but all of the ice makers and warming attendance are coming back December 3rd so let's hope we have a job for them on December 3rd um and then extension another just great information and classes available that you know you can go online to the extension and check out really helpful resources to our community so I think that's all I have to report on that thank you thank you yeah and I I know that the 65 and up is new it was new this year and versus the the kid the power produce for kids has been going on for a few years now and so the thought is that there's going to be more usage as that it becomes more familiar with the 65 or that's the hope at least so and that ties in well with the NorthShore collaborative that power of produce was one of the grants at the NorthShore collaborative uh award Ed um to the north food project for that power produce um and there was a a good handful of other um Grants awarded um down through Lake County and up the shore um Finland in particular um and one one thing we discussed a little bit is there was a program that used funds in different ways than was um applied for and the use wasn't inappropriate it was just different than what was applied for and so um we're asking applicants if and I feel like this is pretty standard if there is a variance and what the funds are going to be used for that they just ask about it right instead of just doing it and then getting reimbursed so kind of a harder conversations um and then um oh oh as far as the lot program the reading program um the grand Marine numbers were low but there's going to be partnership uh with the libraries to try to leverage um reading within the libraries makes a lot of sense instead of outside of that and so we're hoping that's going to do better but there's distribution in Grand Portage as well as the West End um and then in Lake County 2 those were those were still really strong and that's probably all the report there um yeah ask about the power of produce there from the collaborative then has that going is that continuing or was it is set years to do that um so the funds were not fully expended and um the board said go ahead to roll those over and so if there's another application then we'll just take that as it comes I'd expect it would do well um especially based on you know the impact it's had on the community and just nutrition being nutrition especially with kids being such a priority so um but yeah it's kind of a weird a weird situation in that are the funds coming into the NorthShore collaborative or just on the decline kind of continually um so we're kind of just spending down the reserves and other collaboratives around the state have kind of just gone away because of that um but there's still a healthy Reserve um in trying not to just you know get rid of it we're just I mean trying to balance the Impact versus what we got so um but time will tell there um but I'll do my darnest to advocate for it I know the I know the impact U Public Health and Human Services advisory Council um Frank is not here today Frank did reach out to indicate his that he wouldn't be a available to attend have that email this morning oh okay um commissioner Johnson do you have any I don't have my notes for that one in front of me it was a very small group meeting as I recall we got written reports from most partners and I don't remember anything standing out off the top of my head right now that's fine is there anything I was also not in attendence we were a very small group Grace LED that one now I'm remembering that thank you but I have notes to reference you do have notes oh if there's anything again Melissa for being up to date with notes thanks Melissa um so Grace shared quite a bit about the Cannabis ordinance that was passed by the board and some of her um efforts to help inform that process from the public health prevention perspective uh she shared attorney hickin article and then some of the other Outreach that was conducted as a part of that engagement um but yeah Beyond partner updates not much else to that meeting beyond the Cannabis discussion and our prevention Coalition is doing quite a bit of work with uh cannabis education Outreach prevention as well that group meets this afternoon and monthly on the same date as the phhs board at highed okay and Andrea orist is the point of contact for that committee okay thank you um any anything else for the good of the order doesn't look like it that brings us to adjournment have a great day [Applause]