##VIDEO ID:v8rxT2yECSQ## uh good morning everyone I'd like to call this meeting of the Cook County Public Health and Human Services Board to order on Tuesday October 15th 2024 at 8:31 a.m. um first item is the approval of the consent agenda which includes our meeting agenda uh on the consent is the minutes financial report abstracts and bills um approval of children's mental health screening Grant approve the hire of christen Peterson as eligibility specialist approve the hire of Marissa eckel as a Children and Family Services case manager are there any adjustments to the agenda or any items a commissioner would like to pull commissioner yes I'd like to discuss the the two hires f and g please okay and let's see we'll probably move that down to maybe director's report or Z time yeah I'll speak to The Hires under my report and great can ask for board action at that point or during items for action whatever you I just have a couple questions yep all good thank you any other uh adjustments requests else I'd ask for a motion uh to approve so I'll move thank you commissioner stle is there support support thank you Frank uh motion and uh support any further discussion hearing or seeing none all in favor I I opposed motion passed unanimously thank you all down to item three introduction of new staff I'll pass it over to Allison to introduce lety good morning Public Health and Human Services board members very excited this morning to introduce and welcome Betsy bladel to the Public Health and Human Services Board and it's just been a couple weeks now that she was welcomed to the team on September 23rd Betsy is working in one of two office support case a position you might remember that within the last year we modified our economic assistance case Aid position to work within the same job description as our other primary front office staff person Leanne Avery being in that role so really grateful that we have now a fully staffed front office team such a critical team to the operations of our department and service to the public Betsy brings really incredible customer service experience experience working in multiple complex computer systems from her time with the YMCA here in Cook County and we're really glad to have her on board especially as we're launching into the new world of caseworks Welcome Betsy hi good morning um I've been fortunate to meet many of you in different circumstances over about the 20 years that I've been here in the county so so grateful to be part of this team um as she pointed out I have been an office specialist in a few roles here before so at the desk so uh thank you so much for welcoming me here it's been a great introduction with the staff up there Allison's team um and um many of you saying welcome to me as well so thank you very much thank you Betsy welcome aboard and uh yeah thanks we're very fortunate to have you thanks too any any questions for Alison or bets all right have a great day thanks we can move on down to item four our director's report and first let's talk about items fngg if if we might um just questions from commissioner Johnson on this absolutely yeah my questions are do these people live in Cook County um yes one of The Hires lives in Cook County and the other is in the process of relocating to the county and to my knowledge has housing secured here and so the the hire that is not currently living in Cook County are when is the anticipated time that they will start while living here um that is still contingent on their ability to find housing they are actively searching we have staff supporting them and identifying uh housing options um every meeting that they're attending with other County Partners they're bringing up the fact that they're looking for housing so it's really all a hands- on deck in terms of supporting that individual I'm I'm assuming you're referring to David ritmo our recently hired coordinated crisis response worker he is working remotely at this point there's a a lot of content that he can review and go through in terms of online training uh some of the work that's been done to date to develop policies and procedures around our in development coordinated crisis response pilot so he is currently working uh for from his remote location and in the process of identifying housing so any leads are welcome if you're um aware of any housing opportunities that might be opening up he's on the list he's speaking to landlords and Realtors yeah I understand that but my my question is realized I maybe I should have asked this last month which is why I'm bringing it up with these two new hires today do we have a time frame I mean I think the people that work in your office or your department it's kind of important that they are physically here at times I get remote work for some things but it's kind of important that people are actually here able to meet with clients and so I'm wondering how long of a time frame do we pay somebody to live someplace else um commissioner Johnson I can give some context in terms of other direct Service rules it's it's very rare that an individual upon their first date of hire would be immediately meeting with clients or service recipients typically that phase of onboarding to learn the systems to learn the process the policies that govern our work of our department is about 3 to six months so I think that um although we don't have a designated time frame for him to be physically present on site in Cook County six months would be I think a a equivalent uh comparison for other County staff at the point that um they begin working to when they are providing services to community members and I will just express my um concern with that time frame I think we need to tighten that up somehow and um especially with uh um remote the crisis worker when we discussed that last year about that position and how that person for 6 months never ever met with a client and I was informed that we had things in place because of that 6 months that the next hire would be physically meeting with clients and doing the work so I have a concern that we may go 6 months again and I would like to see a training schedule what the actual training is that we are assigning to these new employees that takes 40 hours a week so for just this for yeah no I I guess I would like to see it for all new positions I I don't understand and actually it was discussed at AMC meeting District meeting about the challenges of DHS DHS training requirements and I realize I don't have a good sense of what that entails so I would like to see what that does entail what are the trainings that are required what do we do and how long we expect that kind of training to take and I just met 40 hours a week sitting in a computer doing training I don't know is that what we're expecting I I don't understand so that's the part I would like to see that information I'd be happy to share a copy of our department orientation and onboarding checklist with you commissioner that'd be great uh it's very rare that we are ing someone into a case management direct service role who has the experience to be able to start providing services on day one so that is the rationale for that 3 to six month time frame in addition to as you mentioned the pretty significant onerous training that's required just to operate the documentation system that our staff are required to use yeah I just like to get a better sense of what what we do and how it works so and I will just also reiterate that I have a concern with hiring people and paying salaries for people that are not Cook County residents and I get that our housing situation maybe causes frustrations there but there that is still tax dollars leaving our County and I have a concern with that and if this was posted for 18 months and we did not have any qualified local resident Supply and in lie of having the position vacant this is the best alternative and it's not just computer-based training he's participating in meetings he attended a tabl toop exercise on his very first week uh in which you know for several hours we met with law enforcement Hospital Grand Portage Human Services Public Health and Human Services staff so he's not just doing web-based training he's working to develop relationships he's meeting the folks that he's going to be working with in terms of Department staff and other Prof professional entities working within the coordinated crisis response field question so does he come here when he met with all those people so he got to meet them in real life he visited the county as a part of his uh interview process um he uh in his first week that meeting was virtual so we had it was a hybrid meeting with some of our participants including him attending virtually and some in person at the community center and I would like to see also what you're sending commissioner Hawkins um I'd like to see the Pol or the the the uh onboarding requirements for this position or any position if there's one that covers all of for your department well I was curious you know I think uh DHS has uh maybe uh above and beyond requirements but I imagine that a number of our departments also have state requirements and they didn't know if those are of Interest or if we should take an inventory of what all the state requirements are for all departments what what interesting to know I think I don't know how much of a role HR has in that or if it's just Department based on the state requirements or any insight there I'm sorry gotcha no we're just talking about and then I caught on to like the second half of your sorry what was the first part of that yeah so we're talking about um State training requirements and and just kind of the level the next level that DH d HS has and if there are other departments which I assume such as assessor or auditor that also have state training requirements and just kind of what level those are at as well and I didn't know how much of a role HR actually had in that or if it's just Department by Department that has to ensure that uh the the state training requirements are met right the state training requirements are not they don't fall under my f um I am not 100% aware of all of the State uh requirements throughout the different departments but it definitely is on a departmental basis yeah just with my experience in a couple of different Offices here in the county phhs does have a very significant amount of initial training that you have to go through before you can even look at any client related data um and like the assessor's office you can pretty much jump in right away with on the job training and eventually work into those classes work towards like your CMA um and other level of lur so I'm not aware of any other department or position that requires that level of training right off the bat um I I was going to add a side note too I met with David yesterday virtually to do as HR onboarding um we've had to reschedule a couple times because there's been a couple of hurricanes um that he's had to deal with um but even with David having been on the job for a couple weeks he's still referencing the training that he is still going through so it is a fairly lengthy process yeah Mr chair uh yes please James yeah um I i' just like to clarify some expectations so I understand that there's been a request for the specific training plans for a couple of employees and I'm I'm just wondering first of of all I mean I want to acknowledge commissioner Johnson's concerns I think her her questions are reasonable um I think when we have new employees starting who are not yet in Cook County um there need to be clear expectations about you know what is the timeline for them actually getting into the county um that said I think you know if if the board wants general information about how we train and on board new employees I think that that would be fine um I'm concerned what it sounds like is that we're opening the door to having the Board review training plans for all new employees and that's a level of oversight that is just not appropriate for the board that's really an administrative function yeah and I think I think um I hear what you're saying uh administer York I I think it's a curiosity because of well because we have new hires but um uh also just the discussion it sounds like at the district one um meeting about just kind of the level kind of that next level onerous uh requirements and trying to have a better understanding of of what that actually means so um I don't know that it's it's uh the oversight necessarily as much as a curiosity and and wanting to be better informed um unless I'm Miss yeah that that's great because I mean if you know if the request is to forward all training plans for all employees to the board sure I can see that becoming really honorous that also would be next level yeah yeah right no I gotcha thank you thanks for that yeah thank you um yeah yeah directly to U um Mr jer's um point I don't think it's so much a question of training plans for each individual employee as for a position just like you have a position description you'd have a competency list employees filling this position must be competent in the following areas and this is standard I mean they are published they are nationwide um I'm more familiar with the public health rather than the behavioral health aspect of things but they are absolutely standard and one of the considerations when you hire somebody would be how much training will they need to bring them up to the required competency level some people might be there already and now it's just a question of learning this computer system or you know or that meeting schedule um others may have gaps that need to be and that's fine and that's certainly a um that's certainly a function of of the director yeah um but but again I I think a an overall set not for each individual employee but like just like you have a position description you have a competency level and and again that's that's fa common yeah um yeah that me that makes a lot of sense and then the other the other thing I that I would just like to ask would it make any sense looking long term because this is not a new problem and it is not going to be solved next year um would it make sense to build into the capital budget or Capital plan [Music] um a two or four units owned by the count excuse me housing units owned by the county to be used for the three months higher if somebody needs it they come in charge them rent Char Market rent um but they have a place that they could move into while they're looking for other while they're looking for other housing I don't know exactly how that would work that's something for Eda or the hrd or whatever um but uh just wanted to throw that out there CU something to consider in the next budget cycle yeah I I appreciate you bringing that up we have we have discussed that and um um and and I think we're we're considering it although waiting until the units are um um asking for applicants or or built but yes we are we are discussing that and how that might look alternatively enter into a long-term contract on existing housing units so that these are the county owned or city own however you want to work it um these are the city own available for 90 days possible extension if there's no other demand for it but someone will know they they and that that gives them their their time frame okay you got 90 days to be here start looking seriously yeah and once those units are built I think we're going to have a lot more flexibility with that currently I think it's a little tight to be able to um um find anything long term but yeah I think I think we're trying to navigate that and and include it in the in the budget as well so I think it's a great suggestion and like like the way you think commissioner St yeah I'm sorry final part of the question Amy um sorry Allison um I have a colleague who look very like you his name is Amy or their name is Amy um if if you give us idea of what the housing they're looking for that would help me um be able to steer them toward some things that I'm aware of I'd be happy to have that conversation with you offline Frank I don't know that that's appropriate for a public meeting great commissioner sty thank you yes it was a discussion at uh our district meeting which consists of Seven Counties we get together and I'm on the health committee and it's an ongoing AMC Association Minnesota County's concern and we did have a chance to vote and one of the areas that I voted for was training and how do we handle all over the state we have a situation here but multiply that by 87 counties or 86 because we have 87 so we're working on it at a higher level also for the training and would cooperate then with what you're doing too so it's a it's on board just takes time yeah maybe we can do more at the next meeting in December and so on and so on but it is a highly discussed topic no doubt yeah Allison please um I would just like to add to um in regards to the housing issue it's definitely been a huge barrier recently for some of our um recently hired uh I'm trying to think to say uh individuals that have been offered positions um that are still trying to locate housing including David we still have a uh deputy sheriff who's also moving in from out of the area and his start date potentially could be pushed back as well because they are also searching for housing um during my meeting with David yesterday um he has posted on various platforms he's utilizing Boreal he's looking on Facebook John and I have been sending him um listings just to make sure that he's seen them recently there was a one bedroom one B uh apartment not a not a kind of seasonally long-term rental because we see a lot of those this year being posted where they're like available now through May and then someone has to relocate there was actually one that was a year round long-term rental it already had over 360 some hits wow on it so that is the that is the barrier um in what our potential employees are facing and we have people who want to come David is very aware he wants to get here and he is trying as hard as he can we are trying as hard as we can to try to help navigate and uh direct housing opportunities to our various staff that again that are looking to relocate but man it is it's it's very difficult and like Allison said we have gone for how long without hiring some of these positions children mental health uh the coordinated crisis response worker that David been hiring for but we just don't have anyone locally that is that meets the minimum qualifications that's interested um again there are specific requirements that they have to meet per DHS uh requirements and Minnesota statute to be hir into these positions so we really kind of don't have options besides hiring from outside the county same with our Deputy sheriffs so there are some positions that we do unfortunately kind of have to go through these uh issues and Troublesome situations to just get them here to fill the positions yeah we we uh we struggled with that with our previous Eda director and we'll be discussing it again with our next Eda director and um yeah and I think it's a a pretty pretty regular discussion at this point um back to the the DHS DHS specific um onboarding and training to um I mean obviously the the the next level onerousness is because of the sensitive nature of of the positions and you know um uh a person could ask like okay how much is this costing us to do this training right um another way to look at it too is what kind of liability would could there be for the organization if uh a mistake was made regarding sensitive information you know and think the both both personal uh uh integrity and and privacy is so important but then also just the just that liability I think could be quite great so I think it's important I'm just not familiar enough to know at what level right and that's what I think it sounds like AMC is talking about and yeah the concern here so good discussion um is there is there more we should no okay um well in which case um I guess I'll move the items down to board action then and we'll just move on with your report if that's okay uh Alison okay uh so the updated organizational chart was included in your meeting materials we have had five new hires and promotions since the last meeting which is pretty remarkable given our uh recent uh not so recent ongoing multi-year struggle to fill positions at this point you met Betsy this morning she started on the 23rd uh Nancy Al also started Nancy Deming in her new role as the Children and Family Services Supervisor on September 30th David ritmo started on the 30th as well in that coordinated crisis response worker role uh we will invite David to a future meeting for an introduction when he is here on site so that you can meet him face to face uh as I mentioned he participated in a tabletop exercise in his first week with uh department and uh staff from Grand Portage Human Services nor health and law enforcement he also attended last week's local mental health advisory Council to get connected to other providers and community members that are working to support mental health in Cook County um also just to add additional context to the discussion around training specific to mobile crisis response in order to meet Department of Human Services statutory requirements there are 30 hours specific to that content area that a person must achieve before able to provide that service so that's above and beyond any County Policy onboarding Department policy onboarding and all of the other systems that staff work with uh within our department um on consent agenda um under items for board action now we have Kristen Peterson's hire as an eligibility specialist uh she will be starting with us on October 29th um Marissa eckle was offered and accepted the Children and Family Services case manager position that's the new position that was approved at the August meeting and she has a projected November 12th start date recruitment continues for our children's mental health case manager and licenser position those positions closed yesterday afternoon so anticipate that we'll have a list of candidates referred hope that we'll have a list of candidates referred for those positions yet this week uh Molly and I are working through contract revisions with the temporary social work agency to incorporate her recommendations um have also sent that to County Administrator for review as directed by this board so uh hopeful that we'll be able to have a contract executed in conversations around placement of a temporary worker here in the coming weeks uh overtime expense continues to be a concern with prolonged vacancies in these positions as of October 4th pay period uh pay period ending October 4th we have 1,900 30.4 hours of overtime and comp time paid that expense translates to $813 49 year to date that includes overtime comp paid and leave payout uh when leaving appointment so urge the board to consider the risk of not filling positions that this falls to the staff who are currently working to maintain that uh client care while positions are vacant Alison I'm I'm sorry to interrupt James is just having a little hard time hearing uh oh on the phone you said James so maybe not the microphone can you hear us James sorry sorry I'm on mute um yeah no I just I was having because my connection is by phone I'm just having a little difficulty hearing Alison sorry about that okay okay uh would it but over the phone okay sorry right I don't know Allison if you can move your mic a little closer perhaps well that's what I was like I think that'll be on the YouTube not on the phone yeah I think I have to move the conference unit to increase my volume for you James if you're by phone I can try and project over the mic phone how about that oh we'll do it we Ken okay sorry yeah that makes sense sorry about that no Noe was there a question about the overtime report commissioner or would you like me to no it was just the the volume thing my apologies Allison is that was the overtime offset by budgeted salaries that aren't paid because no one's in the position um I would have to look at the a detailed salary report to let you know with certainty I imagine at least in part the overtime expenses offset by the unfilled vacancies within the department yes thank you um last Staffing update is that we're recruiting for inhome support providers these are not County staff but they are independent contractors who are overseen by our inhome support coordinator um who uh ensure that we provide the necessary oversight for that licensed program and match program recipients with uh individuals needing that level of support within our community so call the office directly and what do they do and is there a particular skill set required um so there's a range of Services provided by our inhome support programs uh Transportation homemaking respit meal preparation getting people to appointments supporting them with socialization Community integration um lighthousekeeping it's not a direct care service so it is not skilled nursing it is like an a support and yeah I've I've known a number of uh inhome support workers um over over the years and currently and um the people that I talk to that that give this support love it it's just such a fun um interaction helpful um and just the the um I don't know the give back kind of thing you know it just is a really Feelgood um service and then the feedback that I hear from the people who receive the support is just it's lifechanging because um getting that help just makes all the difference in somebody's day and world or life you know so it's just a wonderful wonderful program and um can't can't speak enough about it I haven't done it of course maybe I should um but um but I'll I'll certainly keep spreading the word Alis and and what's the range of contract rate um I don't know that off here just roughly how much the people are is it a living way can they afford to live here and provide that I'd hate to misquote um I would say no a person could not afford to live here and um these are very part-time roles so often times people are working multiple part-time roles yeah I want to say it's a 16 to17 an hour rate um private pay individuals might be able to pay more to their provider um but we are um constrained somewhat by the rates that we are able to bill the state for to provide these Services through Department of Human Services waivers so this is a state funded but locally implemented it partially state funded yes there are County tax levy dollars as well that are used to support this program thank you and then there's also the the private side too right there's the different options there's a I think we've had a presentation I don't remember when now not too long ago it's still in my recent memory was that all in that um on the um topic of Staffing and transitioning into Department updates we are actively in the process of exiting the DHS Merit system which is one uh along with housing child care cost of living one of many barriers that we experience in uh filling vacant positions in our department Minnesota Merit system or the timeline or what that's looked like for her as she has really dug into that process I I don't have any specific questions I know just enough to know that other Counties have uh trudged through it and um thank you for the efforts put put there because it's yeah another another another honorous level and um yeah I appreciate looking looking Beyond it any oh commissioner Johnson please thank you cuz actually I was going to talk to you about this afterwards um this came up at the um meeting district meeting from Carlton cuz they are also working on getting out of the Merit system and I wrote it down because I thought o I think we're talking about that so I wanted to get more information on that they are working with the HR Director from Aon C aen County and I'm wondering if you've also reached out in that way to cuz it sounds like she has a lot of experiences with this and they have contracted with her to help them through this process and so I wondered what we're doing to get help for with this process told meliss I've got a mom voice I can project pretty well um yes so I am also actively working with uh Gary Jackson who's with uh Carlton County and Bobby Danielson the HR Director with Ain County I've also reached out to Camy I think this is the year perhaps they're going through their kind of one-on-one consultation with Meritt um so they've already submitted their paperwork to exit where our um us Cook County Carlton and aen are working on our paperwork to submit so yes so I've already been networking um I've also been in discussions uh had some support with um this through uh DDA and Tessa who we work with for our job description review process they do Provide support um and assist counties through this process for an extra fee um I've not gone that route um because of the information that I've already been provided and working with those other two HR directors I don't find a need to have to pay for something that I'm pretty much almost done with but through these various uh resources um yes we're all we're all comingling um and there's it's pretty pretty boilerplate language for filling out the forms um and submitting to to DHS to the Merit system for this uh process and certification to exit thank you for that clarification and hearing that you're working with the other counties so I just wanted to verify that I don't want to recreate the wheel if it's already been thank you gone around and round several times in the state of Minnesota yeah any other questions all right thank you wonderful any other um staff or agency updates I do have a number of other department updates before we move into items for board action wanted to have a more robust report since we don't have a staff report and thank you Allison for being here this morning have a good day Alison all right financial report included in the consent agenda we continue to be over budget and Children and Family Service and out of home placement at 163% and 151% respectively uh we did receive an additional revenue of $1 16,42 uh this is Northstar foster care payments that were received in July these were labeled as quarter 4 2023 uh Revenue but applied to our 2024 budget due to the point at which they were received so that did bring our Revenue under out of home placements to 120% for year to date um again this is also due to the increased in expenditures uh crisis response sorry caseworks is um in full force across the entire agency at this point we had our go live for economic assistance and Healthcare programs on the 23rd uh so week four in the new system for that area of our agency uh within social services staff are an end user training this week with a go live next week wow uh I mentioned the the crisis response table top exercise on the 4th several times um but want to Express gratitude to the staff who planned and participated in that as well as the other agency partners who are all also at capacity but took valuable time out of their Friday morning to walk through that scenario uh which was a individual with suicidal ideation who was interacting with law enforcement and emergency department staff so a valuable exercise for us to talk through expectations what do we want to happen in this situation what has happened in the past how can we get on the same page in terms of how we're working across multiple complex systems that do not use the same language have very different policies and cultures how do we best support individuals in crisis in spite of the complexity and capacity is issues um we also had a emergency preparedness tabletop exercise last week uh that scenario was a severe weather event with freezing temperatures power outages and uh road closure commissioner Sullivan was also in attendance there so I'll save any detail if you wanted to include that in your report our prevention Coalition continues to meet monthly this is the suicide and substance misuse prevention Coalition we are meeting this afternoon from 1 to 2 30 at Cook County higher education with a zoom option as well uh there's been a lot of discussion within this uh community group around cannabis education who the audience is for cannabis education the platforms credible voices to deliver those messages um with a focus on parent education after winter break uh this uh these efforts also dovetail with the lockbox distribution that you all approved the funding for last month through some of our opioid settlement funds in November the group will um have a training on positive Community Norms with our regional drug and alcohol prevention coordinator through the Community Health Board uh in terms of community outreach and events that our staff have led supported participated in uh on September 21st uh are our staff uh supported events in Grand Portage including the first ever Bike Rodeo in Grand Portage bless you uh this was a part of the suicide awareness weekend and the first Bike Rodeo in gr Portage with around 15 people participating uh on September 27th the Human Services leadership Forum took place in gr Portage uh a number of our staff participated in a panel presentation along with gr Portage programs and human services staff I want to thank Andrea Oris Brent Port John speaker and Nancy Deming who co-presented with me along with the gr Portage panelists who included programs administrator Anna Dasha and Leslie Olsen uh at this meeting we talked about how we work across Human Services organizations to support residents specifically in the area of Behavioral Health and Children and Family Services was a great event grateful to the Grand Portage band for hosting um and for the staff involved in this work and it was really a unique opportunity to be recognized as a small community by a room full of State leaders so that was pretty special um Seems Like Only Yesterday and grateful that you were there commissioner Mills to represent the county leadership yeah honored to be there um and as the second Deputy Commissioner that I've gotten to meet so that was pretty neat yeah it felt very new with newly appointed Commissioners from the newly established department of children youth and families and I guess that's the third then never mind sorry and a chance for us to talk about how as a small agency we are really uniquely impacted by some of the challenges with our state systems the lack of functionality how that impacts our ability to be in compliance with IA despite our efforts that's the Indian Child Welfare act uh despite our efforts to be good partners and to do good work in support of Indian families and our community we still have barriers systemically to achieving that 100% compliance specifically around documentation yeah it's very I feel um and maybe this I wasn't aware of it before but I feel like there's now more of a push from the state to be getting out into these smaller communities to hear directly I don't know if that's your impression as well Allison or if there is a published concerted effort there but um I've just been really impressed with that that face Toof face time with State leadership is very powerful um just to just to have that little connection you know it's not like we're best friends or anything but we've met we've talked you know it's it's powerful ready unique point with the reorganization of the state agency to engage in different ways than we had previously yeah so again thank you commissioner Mills for thank you being there and for your leadership at a state level and participating in that Advisory Group as well I think that's a really meaningful way to have our voices heard as a small community that thank you um where did I leave off oh other recent events uh within the last couple weeks I was invited to present to Garay Library staff on Public Health and Human Services programs and services and that was another unique opportunity to connect with another critical Community provider in a different way and look forward to ongoing Outreach in partnership with the library team um in terms of uh helping them connect folks who could benefit from Public Health and Human Services Services programs and support last Wednesday the 9th was Walkin bike to school day last Friday the 11th was Cook County our second ever Cook County warrant resolution day we had three people come to resolve their warrants so continuing to expand the impact of that work want to thank Brenda uh for her leadership there in um initiating and supporting residents uh getting to that event um we tripled the success we did uh and what was reported to me is that two of those the people who participated we had been working with and one was someone who hadn't interacted with our department before so another way to connect with residents in a different way great um continuing Outreach throughout the month for substance use prevention month in October October and then the lgbtqia two Spirit Plus youth group resumed in September on the 18th I'm going to move into my introduction for the business agreement with qualifax unless you'd like to take the Staffing items for board action first go right ahead okay thank you uh so last month uh this board approved a motion um to delegate Authority to me and Contracting with an electronic medical record for Behavioral Health Services that includes mobile crisis response program that is in development and the existing Wilderness outpatient treatment program uh our team met with two different vendors to evaluate and select a system that team included billing clinical and administrative staff um the expense for this system is included in cook County's 2025 Department of Human Services crisis Grant application we have Assurance from the state as well as the arrowhead Behavioral Health Initiative that our request will be funded but we have yet to receive a formal award notice uh one factor that influenced our selection of this platform is that the Human Development Center or HDC is using another qualifax platform for their provision of after hours and weekend mobile crisis response services in Cook County and throughout the region uh this vendor provides hosting as well as ongoing technical support for the software which minimizes the resource impact on our Cook County Mis team uh with appointment reminder and state reporting functionality we anticipate cost Savings in in the amount of staff time dedicated to following up uh with individuals on uh appointments or on information that we need in order to successfully bill for services uh we also have uh persistent issues in our substance use disorder treatment uh medical record with duplicate entries which creates significant staff time burden across administrative clinical billing and Reporting areas the return on investment one pager was included in the meeting materials based on time reported um again this was based on time reported conducting manual eligibility and billing following up on claims issu a lack of integration with State systems and missed appointments um as I mentioned the arrowhead Health Alliance and Arrowhead Behavioral Health Initiative has approved a regional mobile crisis response budget which includes fully funding the request from Cook County which will fully offset the expense of the electronic medical record system um I have Assurance from the state that there will not be any issues with certifying Cook County to provide mobile crisis services and that we will have a contract and certification letter from DHS before September 31st 2024 for the 2025 2026 calendar years and budget years so what I'm looking for today from this board is one of two things uh either to approve the business agreement as it stands pending final review by the county attorney or delegated authority to sign the contract pending final review by the County Attorney so both contingent on Molly's final review and approval yes we're talking about the qualifax we talking agreement qua agreement yes I have reviewed it the only uh thing I would ask is that they show us a Certificate of Insurance of professional liability insurance prior to signing it but it has all the other protective elements that I'd be looking for so I approve excellent I I have a question just um in regards to HDC it's not that there's going to be like U any integration it's just that they also use it and so it's almost like vouching for it right like they've shown that it's been successful for them and so right yes it's not going to be possible to fully integrate with the Human Development Center by using their platform we explored that for some time um as they're serving the entire region and they're providing uh a wide range of Behavioral Health Services as a certified community behavioral health center um so the the strategy to look at vendors that are already in use in the region is yes for that vetting this works here in Minnesota with our state reporting with our licensing requirements and in our staffing model for 2025 we propose being the crisis response provider being the subcontractor with the abhi for mobile crisis response and subcontracting with the Human Development Center through Cook County rather than through the abhi to provide that after hours and weekend crisis response so assuming they maintain the the Staffing that they have this would be a comparable program to what they're already using to provide crisis response Services after hours and weekends thank you um commissioner white has there been much discussion at aha about um you know award these Awards or this transition or no excuse me um no I was there just a couple days ago it seems last week and um Cook County was discussed quite a bit in a very favorable manner about it and you Ellison you had just been there the week before or something like that and so um that was the first time time I was actually there with there were only two other people there but uh everyone else was zooming in but it's a uh I was at Yellow Leaf the uh which was quite an impressive facility actually randomly in met some of the people that are uh getting services or having that as a safe place to house for a while and um and no there was there was no spec as they were speaking I'm understanding that they are really the experts and I have a lot more to learn in what they were talking about so but but Cook County and Allison's name came up many times as did Britney's um what's it Anderson um from Grand Portage so um no we no okay yeah just I did point out that we did get a crisis person hired now but they would have to come to you for details on the uh on the uh training process that is where the person is so and that was the one thing so thank you okay are there um questions regarding um the agreement here commissioner Johnson yeah I just want some clarification so is this a we approve approve this this is a 2024 expense showing up on our 2024 expenses that is accurate there's no way to implement the system and be compliant with the Department of Human Services effective January 1 it's a 4 to6 Implement four to six month implementation period so this will be a a 2024 expense we will receive the revenue in the first quarter of 2025 so we'll either be able to apply that Revenue to 2024 or offset the expense of that coming from fund balance as an unbudgeted expense in 2024 and so that brings me to my next question the revenues then if showing up in 2025 in the budget the preliminary budget that we were presented is that in the revenues in that budget it is not no and it isn't in the revenue is also not reflected in the 2025 budget in terms of the impact that that would have on our staffing expense as well as this would offset the expense of our mobile crisis response provider in 2025 so significant additional Revenue expected before the end of this calendar year as we reported earlier and I think it's important for our board to know because we're having a discussion at the very next meeting about our budgets and it's important that we have all information of what changes and I didn't see that listed on there so we need to be aware where there are additional revenues coming in through phhs that are not reflected on the information we've already received so whether or not we decide to because if it does come January you can do the acral basis you can count it for 2024 or you can say it's 2025 numbers so that's important for the board to understand there's more information that we need to consider when we are making decisions about our budget for 2025 thank you for that clarification and if we could get that dollar amount that would be very helpful I can point you to where that was in previous reports that thank yeah absolutely uh a good question uh any any other questions [Music] here any motions here Mr chair I'd like to move that we approve the business agreement with qualifax credible Behavioral Health electronic record platform pending certification of the professional liability insurance thank you thank you commissioner svin and Rana we have a motion and support further discussion here hearing or seeing none all in favor I I I opposed motion passes unanimously thank you thank you Allison and that uh leaves us with two other items for board action there's um item F that we pulled from the consent agenda that's the the hire of uh Kristen Peterson as an eligibility specialist and then item G is the hire of Marissa eckle is the Children and Family Services case manager are there any motions uh on those two items so we're just going to approve hiring them is that what we're approving or approve if it if it is moved and yes yep the the intention is to hire our um eligibility specialist and Children and Family Services case manager I move that we do that okay we I'll make a second okay we have a motion from Rana and a support from from commissioner suvin uh any further discussion there hearing or seeing none all those in favor I I opposed motion passes unanimously there as well excellent thank you down to committee reports active living steering committee commissioner white uh I did not attend that in in I was in Grand port at the 24th annual Great Lakes uh Beach Association conference they had up there um and then for the aeoa the second one uh they are meeting tomorrow okay and then we talked a little about aha already um Arc commissioner Johnson um well I already informed the regular board but um they will be doing do interviews because w-e retired and so they are doing interviews next week for the executive director position um Phil Greer has been out he's probation person so I'm going to ask County attorney do we they were talking about they made an offer for a probation officer did did that person accept do you know I don't know I don't even know who it is yeah okay so then we had a position probation position that I don't know if it's been accepted or filled yet and but I have a meeting on Friday I will see Phil in person and ask I believe that it has been thank you great thank you um child care solution subcommittee commissioner story we not met okay thank you uh the chb will be meeting um oh I don't know if I reported on a Personnel committee that meeting I had with them um just going going over um trying to keep up with the Joneses as far as um competitive pay and um it's interesting because um so much of it is funded from state grants and the increases are written into the Grant and so there's not always a whole lot of wiggle room but doing everything we can to try to ensure people stay with the chb and and we'll be bringing that to the full board full chb board for for with a recommendation um but just grateful for that foresight and just awareness of of course the the churn and um and the market um um but we'll be meeting um next uh Monday um in duth and then uh we have the L EXC um please Frank if I may add yeah um coming up on the next Community Health board meeting which is Monday the 15th uh Monday the 22nd I'm sorry right mhm or no I'm sorry it's 2 it's it's uh October 21st y we're going to be having a presentation by cdc's director of The Office of rural health and I'm bringing that up here and now because this is open and encouraged to bring in all members of the arrowhead Public Health Community who would be interested um and I believe Allison is sending out invitations to the The Advisory Council to the mental health advisory Council uh commissioner storle maybe this would be something that the health committee of the Seven Counties might be interested in knowing about of course it'll be VI via zoom and we can certainly send out additional Zoom informations the more the murer and The Wider spread that we can get um to uh uh to show director Hall um the level of interest but also to raise your your um questions and concerns with um it not so coincidentally is she she works in my part of Centers for Disease Control um and she's asked me to to sound out the uh the audience on what they would like her to talk about so this is only going to be a top down she's very much interested in what your concerns are it's a relatively new office um they have a lot of resources um some of it Financial some of it informational and like to U extend that invitation um to all of you and U Alison would it be should we send invitations Zoom invitations to the to the Public Health Board um and any other any other entities that uh that you think would be appropriate and um director Michaels has already certainly agreed to this and she's also extending it to the to the other counties that are part of the Community Health Board do you have a time 1:15 okay that's that's her Section the board itself starts at 12:30 but her but her time is 1:15 you can certainly welcome to chime in earlier I believe meetings are open right they are open but they're noticed as open meetings of the Cook County Cook Carlton Lake St Louis Community Health Board I believe to meet the requirements of open meeting law as it relates to the Cook County Board we would need to notice that separately if a quorum of Commissioners were anticipated to be present is that correct Molly I got distracted I'm sorry what was that um so Frank suggested inviting the entire Public Health and Human Services Board to the chb meeting the cook Carlton cook Lake St Louis chb meeting next Monday the 21st uh that is an open meeting of the community health board however if a quorum of Cook County Commissioners were to be present we would need to notice that separately that's right we would need to notice it and we have five days in which to do that three three okay um so I will be there in person however I will be I need to leave early um is there other interest virtual or in person uh to be there I'm sorry possibly possibly yeah I'd be interested yeah so is that something that we're going to be able to notice then we should will we have that time okay could you okay we can do that then we should be able to do that I don't know what the Forum would be um we're typically noticing meetings through other public meetings so Molly I might have to talk to you about that offline in terms of how we notice it as a special meet I don't yeah I think we could we should talk to Janna okay and also I'd recommend um Susan talking with Susan um Michaels because um they can notice for our Courthouse the virtual so I don't know if there's the virtual option available or inperson option um notice you know I don't know how you notice for both that is beyond my I've done that with other organizations so we can work on that work with Jan okay commissioner Johnson yeah I'm just wondering about this and I thank you for bringing that up Frank um is this something that is also appropriate for like possibly the hospital board I would think so yeah sure so I I would try to make sure that they get an invite I think it's important that we make sure we think about inviting all the various entities that are providing services in our community that to make sure we're not we're not in our own Silo and not sharing that information so I'd encourage you to reach out maybe to Kimber and ask that that get shared there also so Alison would that I'm happy to do that should that come from me or should that come from Health and Human Services I'd suggest Susan Susan Michaels our chb director should come should talk to the hospital board I I think that the invite would be coming from sus the chb because it's not phs's meeting it's the chbs meeting so that invite needs to come but what I was going to mention is that commissioner stly is also on the healthcare um Healthcare planning committee which includes satth Mountain clinic and the hospital and I don't know who all so that group might want that invite that might that would be a better one okay kind come from yeah so I don't know who the contact is there though I'd be happy to facilitate that by forwarding the invitation from the chb director Susan Michaels to our advisory councils and the healthcare planning committee which includes leadership from the hospital so so let's talk about the itics of that after this could be a very interesting and then also this does include um the Personnel from Grand Portage um will they be invited yes gr Portage health services staff are represented on Healthcare planning and human services staff and the Public Health and Human Services advisory Council and several staff from Human Services are on a local mental health advisory Council and the mental health human coun mental health advisory Council too because she's very much interested in that yes it's a area of concern not just to us but throughout roal health absolutely it's the top issue identified on most Community Health Improvement plans in the region yeah is mental health yeah well we'll fill the room huh fill the ether a long talk about the um crisis response group and also Scott do talked about um Children's Mental Health Care management um youth groups at the school um they're having some social lunches at the Log Cabin I if is that with students or just adults I don't know I think that's probably the um the students LGB lgbtqi yeah yeah so that's going well and Scott doll talked about from credible minds and he said that it's 11 years before people really get help with their mental health problems that they suffer a long time before they realize it or how to get care or all those things so it's really he said it's like the tip of an iceberg where 83% of people just walking around probably have undiagnosed problems so that's something to keep in mind when you're meeting with people and learning about people and you know it's it's an issue even the smallest things can be traumatic and that compounds over time and just builds and builds just even things you would't even think of you know it's incredible so I think it's great that we're having more services at the school to be able to get kids involved younger to maybe prevent some of this future problem without any help so and we talked about how to stay calm in emergencies um and work on resilience and anything else um State Grant a lot of the same things we talked about today was introduced you know at that meeting so okay thank you if I may Rana just add a couple things to your report the local mental health advisory Council reviewed and gave input on the children's mental health screening grant that was approved on the consent agenda and just to add a little more context around the presentation on credible Minds I anticipate this will get confusing okay in the future as credible as the electronic health record that we are Contracting with for mobile crisis response and Wilderness outpatient treatment program credible Minds is a mental health resource platform that we um are exploring through Public Health Outreach and health promotion it's in use by other uh Health departments Community Health boards throughout the state to share uh evidence-based vet local Regional State national Mental Health Resource information with communities so that was our first demo and presentation of the credible Minds platform boy that is confusing Yeah well yeah I'm not looking forward to that y good well thank you and thank you for that clarification Alison I'm sure I'll need it again um Council on or I'm sorry uh the resort of Justice um commissioner Johnson um well let's see they're still working on becoming their own nonprofit that's in the process and so that they can get some grant funding I want to I brought up the minutes here so I could say this correctly they um Rachel Clark it the was holding volunteer meetings but there it's he Rachel created a Cook County restorative justice Instagram page for those who use Instagram and she was working on a RJ Facebook page so if you're on social media those two you might want to um check that out I have not done that yet cuz I kind of avoid that kind of stuff but I've been meaning to get to it just not so but put that out there because that's where they're going to be sharing more information and so if you're interested in that you can look them up on those two social media sites yeah that'll help get the word out for sure great thank you um Council on Aging commissioner white uh yes they had their meeting yesterday and um I would just there was quite a uproar over um renting uh renting their space to a particular group and I would like to read um the Cook County Council on agent offers its facility the hub for use by individuals and Community groups regardless of race color creed gender G gender identity sexual orientation religion natural origin familial status age disability political affiliation veteran status and or any other status protected by law so the Hub is a is not a county-owned building and they are a nonprofit and their Charter requires that they are apolitical um non-discriminatory and they rent spaces to anybody and this is about social media where there was a person who did not have all of the information but was very unhappy which one can be that that a group was going to be showing movies at The Hub and there were many very unkind phone calls that came into the Hub to start with to the people that work there and to the board chair and then I'm not on social media but but some of the other board members followed it and as a string went through where people joined on the conversation to say to defend the hub's policies the the initial uh initially distressed person um eventually ended up saying well I know more about this now so it just goes this has happened many times in this community social media distorts and inflates a situation or a problem that actually isn't a problem and it is not it's not beneficial to anyone so I would just like for people to understand that if you are reading something on social media it doesn't mean it is 100% true and so before you go out there and then call cause harm and bring on more energy negative energy into a situation that is not does not deserve it and for people to have to take the brunt of some other people's ey for something that is not true is just so wrong and it has happened in this community before and it's it it's not acceptable so I would like to hope the public will understand hand that don't accept what you read on line as truth so there's that they're also having a chili feed on Saturday right three kinds of chili it's a fun so there's that a little balance kind of chilly vegian intrigued Oh Lordy thank you um well I'm sorry that happened and took so much clearly imp was very distressful yeah I saw I saw it on social media and I knew it was wrong but I'm sorry the staff had to be bothered with that because they work so hard anyway yeah very very emotionally trying for them including the cook oh gosh who got some of the phone calls when the other person couldn't pick up the phone anymore oh so to our Cook County community so social networking people you're smarter and better than this um I guess we'll move on to the emergency preparedness committee uh commissioner Sullivan well just uh follow up on director McIntyre's uh remarks we did meet last Tuesday for an hour and a half and the group is committed to doing more tabletop activities uh in the coming year um and as she mentioned it was related to severe weather so the scenario was that there was a windstorm there was flooding part of 61 was Clos down in the area of tofy and um we talked about the fact that the great is closed which changed our emergency routes um but it was a really excellent tabletop and I happened to be in a um Zoom room a pullout room with our um Rowan Watkins director of Mis our Highway Department um Matt nesheim was there and the US Forest Service um had Ellen Bard shanc and one of the really important things that I learned through the tabletop is when they looked at the flooding and this of course was based on a scenario that happened in Cook County not too long agoo soon yeah employees could not get to the tofy ranger station and she would have been there alone um she would have not had capacity to get out to campgrounds to help individuals so it was a really interesting scenario to talk about when Mobility on Highway 61 um is impaired by down trees or power lines or water whatever it might be that it impacts the services that can be provided um to the The Wider community in this case to visitors in US Forest Service campgrounds so I really appreciated the activity it talked about the importance of coordination with the sheriff's department search and rescue prioritizing Road cleanup so that we could get to people that were In Harm's Way um but I'm really looking forward to um having more of these tabletops I think it's really going to improve our capacity to um respond in the case of emergencies and um one important thing that came up um and it's come up before is the importance of making sure that for those visitors that are staying in vacation rentals that they have emergency information that's provided in their vacation rental unit um so they know what to do in case of emergency very good point really excellent practice makes per yeah I just want to acknowledge that uh for I believe the first time at least at a tabletop exercise we had participation from visit Cook County in the chamber executive director Linda jerck was there which was a a valuable perspective on on that issue specifically commissioner it's been really nice to expand visit Cook County the chamber and wtip have been added to our emergency preparedness group and it really helps with communication and if I may I I neglected to acknowledge Andrea tofy for her role in planning developing and leading that tabletop exercise going back to capacity this is a tangible example of how as a stronger more robust public health Team are really able to provide leadership and support on planning and preparing for these critical issues that could impact our community absolutely excellent thank you um healthc care planning committee commissioner starle um we have not met but I'll move on to nio okay thank you because we have met yeah so we um every year we get a new president of the uh health group and this year we have honorable Phyllis Randall from Lowden County Virginia they're called supervisors instead of Commissioners interesting switch on the name but that's beside the point um and she is a goto gal she wants all of us to start thinking about how do we address our whole health and she U feels there's like four or five planks of Health which would be physical Dental sexual moving on to substance uh uh dependent mental health behavior and more education on the entry of opioids and other addictive substances that is um at times taking over our country uh and what about our social health and environmental health and I'm sure the folks in Florida are certainly concerned about the environmental health that's facing them down there and then the effects of social media and gaming on the mental health of our young people and some older ones too it isn't just the younger ones um it was very distressful to hear that she has a concern about a substance that now is being used by some younger people and mostly on the east coast and that is uh nitrogen nitrogen oxide laughing gas laughing gas yeah and it is legal in United States it is quite prevalent online and uh it can be hazardous to one's health because they've added sulfur to it for inhaling so that's something that we need to be aware of as it perhaps moves across the country or who knows if it's already here we don't know but she's quite concerned about that impact so um we have um a lot of things to think about and especially to present at our um meeting in uh the first part of March um and then the director of noik has asked us to by November 4th list our top priorities so probably out of all this I will add that to um to to the list and then on November 6th we're going to meet and talk about the priorities that over 3,560 counties will be submitting to the Health Organization so I have a note to myself to make sure I get that online and that's my report thank you for for working in in na on those issues yeah those National issues I say are right right here too they are um Northeast Minnesota office of job training let's see our last meeting last month we approved a cell phone use policy and we've been working with Bobby Danielson from Aken County and I had an opportunity to thank the Aon County uh administrator and two of their Commissioners for they're letting us use Bobby when we had some HR issues that needed to be worked through and I was just said expressed my appreciation and her knowledge and her um ability to work through the our issues that we did and everything is working well there and I found out she's owns land in Cook County she loves Cook County and I said oh and she says no so I can't ask her if she's moving County she just has land here should keep that name on on your list if we uh ever have any openings for head hunting yeah thank you uh Northshore collaborative uh have not met and I saw it on my calendar upcoming soon here um and then uh Public Health and Human Services advisory Council Frank yeah thank you we had um provider updates and I'd like to just hit a few highlights um the Care Partners is having a um continues to have a monthly lunch and learn healthy education healthy aging education program on the fourth Wednesday of each month at uh Cook County higher ed um and that's an ongoing project um the Cook County Council on Aging otherwise known as The Hub um is working to extend the range of the home meal home deliveries using Frozen uh for frozen meals um working with Julie to try to find weekly drivers who can deliver Frozen takeout to more rural areas uh and they're also getting referrals from sore tooth Mountain Clinic Cook County um Human Services Health and Human Services and local churches with regard to their meal program um the uh Sawtooth Mountain Clinic points out that read brief snippet here since since 2019 uninsured and Medicaid patients in their 20s and 30s especially those without chronic conditions have forgone health care in large numbers that's Statewide locally this aligns with South Mountain climic data showing that many adult patients without chronic conditions are skipping preventive care and accessing acute care more sparingly than they did prior to 2020 so the plans underway to improve Outreach to this age group um and especially let them know that the financial services available sliding scale and so on um in the long-term oun prevention worth the pound of cure um not only is it does this translate to poor health it also U translates the more expensive Health Healthcare so it's something just to be aware of on on the ongoing is V services are not being accessed to the extent that they had been um violence prev violence prevention center gearing up for the school year preparing for a safe and strong program at Great Expectations school and that's a k through6 child sexual abuse prevention curriculum that teaches body safety um and also exploring options to offer safe and strong to the other schools in the county and and October is domestic violence awareness month and we'll be holding a candlelight vigil for domestic violence awareness month today at 5:30 p.m. at the county art colonies Studio One space the 15th today's the 15th right yeah yeah that's today and that's the report from the council thank you Frank uh anything else for the good of the order this morning I may commissioner hot off the presses oh boy just in my email as of good press bad press good press okay good uh Governor walls has declared uh tomorrow which is October 16th as County and tribal Financial worker in casade day so if if I may read that Proclamation pleas to offer some public support for our financial workers in casades whereas County and tribal Financial workers and case AIDS provide outstanding service to people in Minnesota through their administration of Public Assistance programs and these dedicated professionals are responsible for The Prudent expenditure of millions of dollars annually and must meet high standards of job performance in determining eligibility for public assistance and County and tri tribal Financial workers and case AIDS are well-versed in several areas and maintained detailed knowledge of Public Assistance programs ensuring the delivery of of effective services to clients and the public and County and tribal Financial workers address barriers that prevent people in Minnesota from achieving and maintaining self-sufficiency allowing for the highest possible degree of independence from public assistance and Minnesota recognizes the valuable services county and tribal Financial workers and case AIDS provide through the delivery of person- centered culturally responsive case management and excessive Community Services Governor walls uh proclaims uh Wednesday October 16th as County and tribal Financial worker in Cas a day in Minnesota so thank you to all of the Cook County financial workers and casades for your excellent work every day you're here thank you and I should have I should have assumed it was good because it's for the good of the order right just news always gets [Music] me sorry to no no great great yeah thank you any any other for the good of the order Oh attorney hickin please um well commissioner Johnson brought up hiring of the um probation officer to fill the vacancy I did some brief investigation yes there has been a hire it's official and Micah Avery will be starting on Monday awesome they're still looking for a full-time Administrative Assistant up there though so if you know of anyone that's an important role too yeah big time all right well very good we're at the end of the meeting so we are adjourned