almost. >> Good morning everyone. I'd like to call this meeting of the Cook County Public Health and Human Services Board to order on this Tuesday, February 17th at 8:31 a.m. Uh, first item is the approval of the
consent agenda, which includes our meeting agenda, the minutes from last month, financial report, abstracts and bills, and uh purchase uh service agreement with Brewater Health for Crisis Response Services. Is there any
change to the agenda or is there any item a commissioner would like to pull from the consent agenda? >> Please, Mr. Chair. >> Yeah. Um just because I have a question on the uh purchase the agreement with Brightwater.
>> So I' I'd like to pull E just to be able to ask that question. >> Sounds great. >> Please. And with that then I would make a motion to approve the consent agenda as presented with that edit. Thank you, Commissioner Gamble. Uh, we have a motion as our support. Frank has support. Um, one thing I did want to
point out as discussion before we approve everything is the change to the agenda from the emailed agenda. It includes an item 5B, which is uh a contract amendment with Birch Park Consulting. That's Megan Modes.
>> Um, just so everyone's aware of that. >> But other than that, any other discussion? Hearing or seeing none. All those in favor? >> I >> I opposed. Motion passes unanimously.
>> Thank you. >> We'll move on to Well, maybe we can answer your question first, >> Chris. That'd be great. Thanks. Yeah, it just uh pretty simple question. Um and that is this uh service agreement with
Brightwater. is that um has how has that changed? I'm assuming we we do this you know annually and just wondering to the extent that it's changed from what our previous agreements have been. >> Sure. I'll do it's a bit of a preview
for the presentation. So I'm just going to try to answer the question as >> uh you know concretely as I can but then it'll continue on in the presentation. So um under statute to provide mobile crisis we have to be able to provide
that service 24/7 365. Right now the way Brightwater is involved is they are covering the service um after hours and weekends. They're also providing clinical supervision. So that portion of this
agreement looks the same as it did for 2025. The addition is that we added in a portion that allows for our staff to go to Brightwater and shadow their staff because one of the challenges we've had with training in staff is our low call
volume. So to be able to go to Brightwater and in a higher volume setting shadow staff that do this work as well. Um that's now written into the business associates agreement. That's the only addition that's different from what it was in 2025.
>> Okay. Thank you, Gracie. >> They also are providing clinical supervision at this point. Um although that will shift at some point this year likely as we have our new behavioral health supervisor on staff and training into her role. >> How long have or how many years have we
had this agreement? Oh, I know we had it in 2025 and it uh shifted somewhat because when we the previous behavioral health supervisor was in his position, John Speaker, he was acting as clinical supervisor. So,
the agreement shifted at some point to include clinical supervision um after that role was vacated. So, I'm not sure. I'd have to do some digging as to when we started to have the um agreement with Brightwater, but it's been several years
at this point. Plumbing, >> our agreement with Bright Water was signed during my tenant as an interim director because we needed um >> after hours um um after hours coverage and supervision
for our team. So, it was signed in 2025. >> Okay. I'm just wondering given the service provided that um when Brightwater began its operations if if we were looking for
that resource and made that agreement at that point in time. So it it just sort of looking back and seeing from the standpoint of as a county when we were looking for resources when Brightwater began and and maybe um it was my
understanding that they haven't been that longstanding but I might be >> it's HDC. >> Brightwater was formerly HDC. >> Um >> it is like the the after hours and the weekends has gone I mean since I over seven years.
>> Yeah. the after hours weekend portion is somewhat separate from the clinical supervision. >> Yeah. >> Um so when they started providing I mean I'd have to go back into the specifics of the history as to when they began
after hours and weekend coverage >> for Cook County. And and the last portion of that is the financial component as to how we've seen anything change in that regard um with with this agreement as to the hourly
rate. >> Plum, I may need to defer to you. I do know at this point the services that Brightwater is providing um are covered under the mobile crisis space grant. So it's not coming from levy. It's entirely
coming from the mobile crisis grants that we're providing and there's not an additional cost to having the ability for our staff to shadow at Brightwater um as to the exact hourly rate and I I'm not um I I'm not going to be able to
quote you what that is at this >> point and I appreciate the conversation the context just understanding as things change you know moving from year to year what we're seeing in that regard and as we evaluate and see the benefit to us the addition of being able to shadow was hugely important. So, I appreciate it.
Thank you. >> Absolutely. >> All right. Thank you, Commissioner. Oh, uh Frank can go ahead first. Sorry. >> Uh so, Grace, I just wanted to clarify when contracts Brightwater and similar that we discussed in the past come up.
Uh is there an RFP put out or is this like an automatic renewal or >> In this case, the provider? >> In this case, there is not. there's one provider that's been doing after hours and weekends. Um, and so it's not there's not a wide field of providers to
choose from. They're the provider that is providing this service after hours and weekends. And so we're continuing to um contract with them. >> So providers >> at this point possible choice. Uh yeah, and I I would say I would probably defer
to Kristen as to what our policy is as a county for when we would put out an RFP versus continuing to contract with a provider such as Brightwater for a service like this. >> Yes, thank you, Grace. So, I would consider this like a sole source where like Grace had mentioned, they're they
have historically provided this service. They're one of the the few that provide the service within the location. Um, in terms of a policy, like Grace stated, um, I'd have to defer to Brady on if we have a sole source, um, policy in place, I'm not certain. Um, but I can look into
that. >> Thank you. >> And I just did a quick search. Uh, the earliest I could find is 2018 for HDC contract. Um, and I think that was from the previous of 2017, but
>> give some context. But Commissioner Svin, you had you had >> I just wanted to make a motion to approve the purchase of the service agreement with Brightwater Health for the crisis response services. >> Thank you, Commissioner. Thank you, Commissioner White. Motion and support. Any further discussion?
>> Hearing or saying none. All those in favor? >> I >> same. Motion passes. Thank you. Uh thank you for the discussion. Thank you, Grace and Plowman. and we'll move on to our staff report mobile crisis
response presentation. >> Sure. So, this will be a continuation of our discussion just now as to mobile crisis response has been a topic that's come before the board several times in p past years. Um, and so this will be a
co-presentation between Sarah Eisenrich, who's been acting as our mobile crisis response worker, um, since she returned to the agency as a temporary staff in the month of October. Andrea Or who's been acting as uh a project lead in
addition to her work as public health educator bringing with her experience as a contracted employee in the past with Brightwater who's been providing those after hours crisis response services for several years. Um she's not working in that capacity on this project but brings
with her that knowledge and experience from her past work. Um, so when there was significant staffing transition in the summer of 2025, the mobile crisis response project moved under public health and the three of us began working
together to really stand up a pilot. Um, and so we're going to be because it's been several months now and we've had this pilot operational, it seemed like a good time to bring this back to the board's attention so that we can remind the board of what it is that we're
doing, why it is we're doing that, and how uh the pilot has gone in the past several months. Um, we're not at a point yet to be making decisions about how this service might change in the coming months, but I do believe that in the coming months we will get to that point. So, I want to make sure that you all
have the context and information and the ability to ask questions now and again, of course, in the future, but that we kind of give you an update as to where we're at with the mobile crisis team. So, with that, I will turn it over to
Sarah to give a brief definition of what mobile crisis services are. >> Good morning. >> Morning. Okay. Is that better? >> Kind of. You have to like be right right in. >> We're live.
>> We're waiting now. So, >> okay. Good morning all. >> Good to be here. So, um, in talking about what mobile crisis is, it's a 247, um, um, response
um to and services to individuals experiencing a mental health crisis. And that could be in their homes, in the community, or other sites outside the usual clinic setting.
Um, mobile crisis response teams can help address and resolve mental health emergencies, cope with immediate stressors and suicidal ideiations, identify and using strengths and additional resources and available
resources. Work with individuals, families, and providers to address immediate needs. um develop action plans and connect to needed services and really help you know beginning to return to their baseline
level of functioning. Why oh um why is mobile crisis response important? Well, first and foremost, it's a statutory requirement um for all counties and a mobile crisis
um response provider must be a county board operated entity or a provider under contract with the county board in the county where the service is provided. Um, also, um, mobile crisis can prevent
situations from escalating into emergencies that require hospitalizations and law enforcement. The statistics out there are actually amazing. um what's happening in Minnesota and mobile crisis is a vital piece to an integrated mental health
system, especially important in areas where behavioral health care options are more limited in rural areas such as ours. And it provides connection to ongoing support, provides stabilization, and a link to additional resources to
help address the root causes and promote long-term recovery. So, I'm going to talk a little bit about our partnerships and collaborations, where we are and how we got here. So, um, like we sort of already talked about
with Brightwater Health, they provide our after hours, uh, mobile crisis response services, our clinical supervision, and then they also provide backup staffing if um, Sarah is out of
the office or potentially on another call or something like that. And then I would also say that they've been um imperative in our process to build this program really bringing a lot of expertise and knowledge and information
to you know stand up our pilot. Um first call for help is the call center where um our mobile crisis response calls are received. So, um they receive calls from
988 211 and the Arrowhead Behavioral Health Alliance um crisis line and they hold. So, we have like a an agreement with them that outlines what
when a call comes in, how they triage it, and then how it gets and when it gets to mobile crisis response. Um they can also provide triage services over the phone. So if somebody just needs to talk, they can do that. If
somebody requests mobile crisis response specifically, then they make that transfer. Otherwise, they work with the person to determine if mobile crisis is, you know, the service that they would like. Um the Arrowhead Behavioral Health
Initiative is um the agency that we work with for our mobile crisis grants and they have also been really important in providing um help to build up our pilot.
And then we also collaborate with Sawtooth Mountain Clinic, Grand Portage Human Services, Northshore Health, and the uh Sheriff's Office. They are all part of our coordinated crisis response group. So this group has been working
for multiple years to um try to streamline and um improve working improve the the track of services that somebody um
intersects with if they're in crisis. Um our current service Oh, hold on. too many buttons. Our current service. So, right now we have one full-time mobile crisis response provider Monday through
Friday. Sarah, yay. Um, we currently have our clinical supervision, our backup, and our after hours coverage contracted through Brightwater. And sort of like Grace talked about, we have a functioning
pilot uh program. So um how we got here and that will sort of lead into a little bit of what our pilot program looks like. So through the existing grants that we have in place uh
with DHS and through support from Brightwater First Call for help, ABHI and DHS um you know we had to we had to put the service on hold for a little while until we got that Brightwater contract in place for the clinical
supervision. And then it really required doing a lot of program research and um implementation. Well, me, Grace, Plman, all of those collaborating partners. Um,
we had policies that had to be put in place that were were required by DHS. We really just had to figure out what it looks like when a call comes in, how you show up, how you um provide those safety checks and situations for the mobile crisis staff that's going out in the
community. Um and then we also through that collaboration with the coordinated crisis response group um you know have been able to really define what our service looks like through those
policies and procedures and things like that. Oh yes. Okay. So part of our um building of the program through our uh mobile crisis grant we did a
a media campaign with Giant out of Duth. So um we had we put up the billboard back up on the east end of town um a little bit farther out than it used to be. And then we also
have paid social media ads for um 988. And then we have some print ads that are probably out. I don't read a lot of print things, I guess, but on mobile crisis response. And then we also did
two countywide mailers. The first one was in Decemberish and that one was specifically for 988 services. Um, and really to what I learned through talking
with people was that, you know, they didn't know that 988 was a service that they could use or, you know, when most people think of 988, they think of like you have to be in crisis and you really don't. It's just if you need somebody to talk to and you don't know who that somebody is. Um, but then they can also
get you to other services or mobile crisis response. And then the second mailer came out in January and that one was specifically um geared toward mobile
crisis response. And that top the top two images there are both sides of the mailer um to help outline you know what services or you know how mobile crisis might support someone. And we did I don't have the data with me
readily but I can share the data. The um you know the the number the amount of engagement that we had from the digital ads was um higher than the media company expected it would be. So we were pretty excited about that.
And our goal with that is that it would increase the call volume cuz if you're providing a service you want people to know what's available and to use it. And um so our goal is that it will increase the call volume. So we'll be able to
track separately through first call for help how many calls come into 988 versus the um Arrowhead Behavioral Health Alliance is the 844 number that we share specifically for mobile crisis response.
And then we can also see how many of those calls make it to mobile crisis or how many of them just you know were resolved over the phone with the first call for help staff. And I will add one more thing before I
move on. The reason that we use the 844 number um the ABHI line for mobile crisis instead of 988 is because that's also the number that Brightwater uses.
Um so it's the same phone number 24 hours a day. You can access mobile crisis through 988, but it's more direct through the 844772 4724 phone number. Um,
and it's also, you know, it it felt natural to share the same phone number that Brightwater was because they're providing the service outside of the hours that we are not. So I can talk a little bit about next steps. So the first one um we can sort
of check this one off because we just talked about it. Our continued collaboration with Brightwater on service provision. So we are continuing to work with Brightwater for after hours weekend coverage as well as backup coverage when we have a staff who is
unavailable. Um that is absolutely key. I mean to set up a 247 service is challenging uh for larger counties and for a county like ours with the call volume that we have and the staffing we have it's extremely challenging. So to have a partner like Brightwater helping
us meet that statutory requirement is very important. Um they've also really the clinical supervision is is required by statute and as we bringing on our behavioral health supervisor who will eventually take that piece on um it's
important to have enough overlap to make sure that she has time to really train into her position. Um, we have continuing to work with our coordinated crisis response team on reviewing the University of Wisconsin superior needs
assessment that will be included with the minutes. It's not something that we need to discuss in detail today, but I do want you to know that it was completed. This was something that was in it was a deliverable under the startup grant for mobile crisis response and that was completed in the fall. Um,
we have brought it to the con coordinated crisis response team for review and it's going to be a longer conversation as as to how we want the service to evolve over time. But there are some recommendations based on how other small counties are doing mobile
crisis that we can look at as we decide the path forward. Um, as I said before, mobile crisis moved into the public health team over the summer. The plan is for it to move back into the behavioral health team um but with support from
public health. There's a component of this that is that outreach education the trainings that we've done in public health to let people know that 988 is an available service that I think makes makes it make sense that public health will continue to have a role in mobile
crisis. But it won't be the same role that we've we've been playing to date just because we are staffed with behavioral health supervisor again and this is a behavioral health service that we are providing. The next on this list is to research
potential options for the provider of record. So we are currently as Cook County PHS the provider of record which means that we hold the license to provide mobile crisis response services. Um we are exploring whether it's would
be possible for an entity such as Breitwater, First Call for Help, another community partner to um to provide that. However, there's it is very preliminary. We had a meeting on um January 29th
facilitated by Dave Lee who's been working as a contractor with PHS that included partners from Brightwater, from First Call for Help, Graham Portage, the clinic. Um and it was really just to have an open conversation on what our future options are. So at this point
there's really it was a very preliminary conversation on what the best path forward might look like. Um, as the provider of record, we have our own policies, procedures, electronic medical records, software system. Um,
we're really providing this service quite independently with, of course, support from partner agencies like Andrea explained. Um, but the next step regardless of kind of how this evolves is to continue to build and refine our program to make
sure that we're providing the best service that we can and remaining in statutory compliance with what the state sets out as guidelines to for mobile crisis response. Um, I'm very proud of the work that Andrea and Sarah and Plowmen have done
to have to set up an operational system in a very short time period. Um, our call volume has remained low, but that doesn't mean it's it's nothing. We have had successful response calls where we've gone out in the community and piloted the policies and procedures that
we've put out in place. It's remains low, but as Andrea said, the um communications campaign and some of the partnership building that continues between Sarah and Andrea has really tried to make people aware that the service is available locally so that if
people need it, they know how to access it. Um, which brings me to our last slide here of how to contact mobile crisis response. There's two avenues and they'll both get you to the right place. One is 988. uh that's nationwide. Then this other
number, the 844772-4724 is specific to the Arrowhead region. So either one of those options if you're looking for mobile crisis response will get you back to um our local team during business hours and after hours to
Brightwater who's providing the service at the moment via teleaalth. They're also looking for more contracted employees to work within the county during uh evening and weekend hours. So, if you or someone you know are experiencing a mental health crisis or
need someone to talk to, go ahead and reach out. Uh like I said, both of those numbers will get you to support. And I'm happy to take questions or have my colleagues here take questions as well.
>> You have a question? Uh yes. Um where is the 844 number? Is that just for not for the person who's who's having a crisis? >> They do they call that or would that be
>> Yeah. Anybody can call that. You can call that for yourself or you could call it for somebody else just like you would with 988. >> And where is that number plastered all over like 988 is? It's not as it's not as um it's more digits and it's specific
to our region. So the reason for providing them both is to provide options that the 844 number is is a more direct route to get you to our local call center essentially. >> So I I was just I was just wondering how people find that number.
>> It is on our mailer. Most of the promotional materials have 988 because it's just it's an easier it's an easier number to remember. Um but both of them will get you where you need to go. So I think it's on our mailer. It's on some of our um materials that we've printed
locally. Yep. the print ads that went out in like Northern Wilds and the News Herald and whatever other print resources we have. Um, it's printed in those ads and part of the part of the
building of the program really was trying to figure out how the best way for people in the community to reach our staff. And um what we decided right away was that calling the front desk was not the best option. So um and because first
call for help is a professional call center for these type of calls. Um so through that building out we have um sort of draft business cards I guess I would say. Um and they will have the 844
number bigger but also 988. um it's really in the sort of preliminary process of putting that information out. >> Okay. And then my next question was or statement was that um in the beginning
speaking personally I thought 988 was if you were suicidal you know not me but the 988 if you just need someone to talk to. I think that is really an important part
>> to get out because there are so many people that are so alone. Maybe not alone where they live but alone in their head and and don't feel comfortable. But if you're just a phone call away with
three little digits, they might hit bottom and decide to dial 988. >> Right. And that was sort of the when we worked with Giant on the first round of um the media campaign for 988, you know, we really stressed that, you know, we
wanted that message to come out also because it's called the 988 suicide and crisis hotline, right? So, um you know, I think the billboard hold on. Oh, yeah. you can talk about the small
stuff too is the message that you know they created around that. So hopefully you know that message is getting out there. And I have one more question promise. Um if I can read my writing. Um
shadowing. How many uh of our employees would shadow? How long does that take? Is it a day? Is it a two day? Is it an hour? just curious. >> Well, the first step was to get into our business associates agreement the
ability to shadow to have all of to have our county attorney look at that business associates agreement and make sure that it was up to our standards and for Brightwater to to do the same. So, that's the point that we're at right now. Sarah would definitely be going to
shadow um and likely also our behavioral health supervisor. Those are the only two staff that we've identified at this point who would go and we haven't worked out the logistics of when. Um I'm hopeful that you know within the next
month we can set something up and whether that looks like you know they're going staying the night and having like two days there um or if they go and then come back is still to be determined. I I would assume it would be one of those
one of the two options. Um, and then we'll have to work out long term uh what the right cadence feels like because I do think it is best practice to have somebody frequently, you know, witnessing inerson responses given our
low volume and if we have grant money in our to support that travel and shadowing, I think it would be a good use of our resources. But we don't have a specific uh plan built out yet. I have that. I'm sure we will by the time we meet again in March.
>> We'll hold you to that. No, thank you. Thank you for that information. >> Frank, >> Grace, um I I work much better with concrete things rather than general things like behavioral, mobile crisis, like
I want to get down into the dirt and say, "What does that actually mean?" Okay. So, I have a a visitor. My son comes to visit and he's going through a um what I consider a crisis. He's not suicidal, but he's ranting. He's raving. He's throwing things around the house. I
dial 8447724724. Who do I get on the other end of the line? >> I think I'm in a >> business hours. Business hours. >> Andrea and Sarah take this one. >> So, no matter what time you call the 844 number or 988, all of those calls are answered by First Call for Help, which
is the call center out of Grand Rapids. >> Okay. Can I tell them my son's going crazy? I need help. >> So, what they do is they they would probably start by asking safety questions first um to determine if it's a call that they can
field with you or if it's a call that would be more appropriate to um the sheriff's office. >> And so then they go through a screening process and they ask questions. Um I don't have it pulled up but you know they go through the screen screening
process that asks you know >> questions like are you having um thoughts of suicide? Are you having thoughts of harming others? There's you know a standard set of questions. Um, and through that process, then they would work with you or whoever the
caller is, and potentially then if it's a a third party that you're calling on behalf of, you know, the three of you would work together to determine if a mobile crisis response staff is what the service that they want or that you want.
Um, and then they would engage, they would transfer the call. >> Does that mean Okay, so we get through the screening process. Okay. He he's not a threat to anybody else right now. We don't need an armed response, which as a parent who has had experiences like
this. Extremely reluctant to call police because I don't want my kids shot. Um but it definitely needs some kind of help. Does somebody drive up to jail or do we try to get on Zoom or >> um Well, first of all, that's a decision
that the person gets to make on their own. >> The person that's in crisis. >> Yeah. >> Well, he's in crisis. He's not. Okay. All right. My daughter, >> best practice is that the mobile crisis response person shows up in person and provides that face-to-face response. So,
um, you know, we have to go through so the call would be transferred to the mobile crisis response staff. They would do their own screening and talk through the situation and gather the information. And then the staff person
has to contact their clinical supervisor for direction on what the next steps are. >> And the clinical supervisor, again, someone remotely. >> Yeah. That's provided by Brightwater. Yep. >> Provided by Brightwater. Okay. And so then under the direction of the clinical
supervisor, the mobile crisis staff will um I mean best case scenario the mobile crisis staff drives to where the person is or sometimes people want to meet somewhere else or um you know they don't some people just don't want you to come
to their house either. Um so which is why I say you know it's sort of driven by the person. Um, and then once that piece is once they go they arrive or get that person on the phone, then they go through an
assessment process, which is a whole another set of questions. Um, and at that point, then they can consult their clinical supervisor and talk about what resources the person might need. Do they need a higher level of care? Do they need some referrals and things like
that? work through a safety plan or um what's the oh something like a safety plan >> safety >> um >> I'm sorry
>> during business hours and and you're not doing shadowing in duth or something uh you would actually be the person who either responds on phone or drives up or whatever. And outside of business hours, the Brightwaters send somebody up or put
somebody on the phone. >> They um they would follow the same steps, but right now Brightwater only has teleaalth services. Yeah. So that would be phone or potentially video because they don't have anybody in the county um doing that per in-person
response. >> Okay. But did I understand that they're kind of looking for an on call person to do that kind of thing? >> Yeah, they do have the position posted. >> Okay. Okay. For local. >> Yes. >> Thank you. That that helps a lot. That helps a lot because >> I you know I don't with these
generalities. Okay. But >> it it it kind of loses something when I have to think in in specifics and I realize that. So thank you very much for >> crisis intervention plan. That's >> intervention >> safety. Mr. G. Thank you. Thank you, Frank. Commissioner Gamble.
>> Thank you, Mr. Chair. Um, what's the inception of mobile crisis response? When did it begin and who instigated it? >> I believe that, um, it was DHS, so it was at the state level. Okay. >> And it was about a decade ago that it
was written into statute. >> Okay. And the reason I ask is that um if if you recognize a need and then you want to put something in place to address that need, how how you frame that. In other words, what you name it. It'd be interesting if if you were to
just go out and survey people and say mobile crisis response. What does that mean to you? And um what you have to do is that if if your name isn't reflective of what what the service is then you have to couch it in language that
supports what it actually is and then it gets elongated. That's why with the short number we're trying to given the nature what it is the service we're provided we're trying to make it succinct so that people it's it's a response and we want that to be timely. mobile crisis response. The first time
that I heard it sounds like given where we live that if I've got somebody that's stranded up in the Boundy Waters, I I have somebody that goes and helps them. And so mobile crisis response doesn't directly uh connect with the service that we
provide unless we give that definition some way to make that what we mean. And so that's that's one of the problems. The other is is and in my mind it it's a problem because
uh it it doesn't directly tell me that it's a mental issue. >> It it's it's a response to a crisis. >> I think um I will say that the ongoing we have several ongoing projects associated with this uh
service. One is to let the community know what it is that we do and that how they can access it. >> Another is um to work on the on the prevention side of things. So to do some of the community mental health trainings
um that we've done in the past. So um mental health first aid for example or Andrea and Sarah Waddle will be doing a train training called Comet with higher ed later this month that is really helping people support other people by
recognizing signs of um mental health challenge and um support mental health well-being. I can let you say more. That's my general understanding of the comet training. So that general community kind of first aid type training related to mental health is one
piece of this so that hopefully people will seek out support before it reaches the level of crisis. And the other is to let them know you know if they are needing immediate support that mobile crisis could provide what does that mean? How do they access it? Those are both ongoing projects for our department
um for you know the rest for for a very long period of time because they're they're they're projects that take a long time to to come to fruition. But I feel like we've made some good progress in those areas. Yeah. I think that you know before we really started to promote
what the service was, we had to be able to provide a service um and meet those requirements. So now that we're at that place, we can really start to focus on that outreach piece. Um, and I'm also
doing a presentation at the emergency services conference in May on mobile crisis and I'm doing it with Molly Johnson from Carlton County who is our um regional suicide prevention coordinator. So we're doing a dual 988
mobile crisis um presentation at that conference. So that will help um bring that level of information to the service providers that attend that conference. >> Yeah. So so my my question just first do
people understand what it is and and if if we you know like to Frank's question just practically speaking that we have to do a lot of marketing so that our branding is associated with the service that it's providing. The other is, and
you made it, Andrea, your comment about the the correlation between um policy, statute, and whatever in what we're able to do. And in the discussion that Frank brought up too in the scenario that he
presented, consent, consent is sort of foundational. And this this is where I I see the conflict is that a person in need who is not thinking rationally and is in crisis and we recognize it and we
want to help that individual. But if the consent doesn't happen, we don't fulfill the need that we say that we're providing. That that is very very frustrating. And so what I would say is that all parties that are working
together, whether it is the legislature, whoever drafts the policies, that if if our policies encumber our ability to do what we say we want to do, we've got a problem. And um uh in in personal experience uh dealing with a number of
individuals, I cannot believe the the the nature of what defines crisis and our ability to respond when we don't have consent for the person that is creating the crisis both for themselves and for others because our policy
encumbers our ability to respond. >> Right. I would I guess that's that's true. We can only provide service if somebody consents to it. Um if it be if somebody is a danger to themselves or others then we have to involve law enforcement under the statute. But we
can provide support to someone sort of working with somebody in crisis. Right? So, if I have a friend who is in crisis and I don't know how to support them, they don't want the support themselves, I can get that help for myself to try to
figure out how to help them and build that process with them maybe. Um, which is partly what the comet training will be about. It's sort of a a pre-QPR, so it's really um connecting with somebody before they get into that
feeling of crisis. I would also add that um the the person in crisis really gets to define what their crisis is. Um so >> that's a tough thing. >> It's it's very broad and that's why we
have the expertise of clinical supervision to really walk the staff through what the steps are and what needs to be done. And and one other comment, I thank you for the time and the conversation is that this is a pilot program theoretically that that we are
running. And if you if you identify upfront what it is you hope to accomplish, what this will provide by way of service to our community, if you can clearly identify those things up on front in a pilot program, in order to
evaluate that, you have to be able to connect those objectives when you do your evaluation. So when we look at we look at all these things and then we say, how effective are we? what gets in the way of being effective and what can we do to change that to be more
effective. So I I would just encourage that we can learn as much as we can because we see that there's certainly an accelerated >> sense of crisis that existing for multiple reasons and our ability to respond to that is is hugely important.
So thank you for your work. >> Thank you Commissioner G. Any other questions? All right, thank you very much for the presentation >> um and conversation and um and we'll
stay tuned for for how things develop. >> Have a great day, >> Frank. Go ahead. >> Yeah, great. Just roughly, I know the call volume is low and that's good. Kind of. Yeah, it's good if it's not there.
Okay. Um, what do we talk about? Like one a month. >> One roughly >> about one a month. >> Roughly one a month. >> Okay. Thank you. >> This moves us on to our director's report. >> All right. Well, I'm going to start with staffing updates and our org chart,
which if you pull that up, looks very similar to the way that it looked last month. I will note that late Friday afternoon we did have an offer accepted for the public health supervisor position which is very exciting. Um Avan
Sukwal who goes by Avi has accepted an offer for the position with a proposed start date of April 1st 2026. He will be joining us um moving here with his family from Freeborn County where he's currently working as a public
health planner. So that is very exciting. Um, you'll note we do have a few vacancies which are currently unposted and that is purposeful as we're waiting for Megan Mo's report to come out next
month. So, uh, at this point we have no other posted positions within our department. And that brings me to the rest of my report. So, um, on February 12th, I did
receive notification from MDH that the CDC has canceled the public health infrastructure grant for Minnesota effective as of February 11th, 2026. Nationwide, 107 health departments
across all 50 state states received this funding, but only Minnesota and three other states are having these funds canled. Later in the day, on the 12th of February, MDH noted that attorney general for Minnesota, Keith Ellison, and other attorneys general from three
other states filed a lawsuit challenging this federal action. Late Thursday, a judge granted a temporary restraining order. This is effect in effect preserving the funding while the case proceeds and will remain
in effect for 14 days. For context, this is a grant that we have locally. The grant period runs from March 6, 2023 through October 30th, 2027. Our original
grant award was for $30,728 and we have $20,979 remaining to spend. This funding primarily has supported travel and training for public health staff with the possibility of using
these funds to support public health staff time. Though it is currently not budgeted in this way, this is a situation that we will be following closely with our partners at the state. And another contract related update, we
are cancelling a moving greater Minnesota forward grant contract that we had with the Minnesota Department of Transportation in the amount of $4,215. This is a grant that was intended to build out scheduling a scheduling
website for the Boreal Transit Van and to provide marketing materials for the service. To be clear, we still will own the Boreal Transit van and we will need to further assess what it would take to operationalize a handicap accessible
transportation service within the community in terms of staffing, policies, procedures, etc. Ending this contract with Mindot allows us to remain in good standing with Mindat. When speaking with our grant manager, they encouraged us to consider
applying for future funding opportunities. And the reason was really within the grant period, we're not at a point yet, nor do we have enough money in the grant contract to create scheduling website for the service. There's several foundational pieces that
we just do not have in place. So cancelling the contract allows us to remain, as I said, in good standing with Mindat so that in the future we could consider applying for funding again. Um, I'm going to keep going on the
funding uh vein here. Um, so there are I wanted to bring the board's attention to a variety of state websites that are tracking news related to federal funding for PHS services
because we've these types of grants have been in the news quite a bit and this is a source that is reliable, fact-based, and it's what I'm looking at uh as I get updates from our state partners in delivering health and human services
programming. So the department of children, youth and families has a federal funding tracker. I'll include the website in the notes for my report that monitors federal actions that could affect benefits and programs for motans. It includes which issues the state is
monitoring and which are in litigation. At this point, I want to stress that all programs and benefits are still available without changes. However, I continue to follow these developments closely so that you all as board members, our staff, and the community at
large have updated information on how benefits and programs may change in the future. DHS has created a fact check page which I'll also provide in my notes that provides accurate information on fraud in Minnesota as well as what state level
officials are doing to fight against fraud in state administered health and human services programming. This is in addition to a program integrity site that provides detailed information on what the state is doing with regards to fraud and state administered
programming. Finally, um, with regards to the popup pantry, we've received only three survey responses to date. The most notable learning from these responses is that guests who are using the popup pantry
are using it frequently, which indicates its value to our guests. We will continue to receive responses through March, and we'll present a more detailed synopsis at the April board meeting. Um, and that's all I have for my director's report.
>> Thank you, Grace. Any questions for Grace? Commissioner Gable. >> Yeah, thank you, Mr. Chair. Thank you, Grace. The um with the transport van um that was that was given to the county,
correct? Donated to the county. >> We did purchase it using grant funds. So my understanding and the question I have is that if if we have a transport van that we acquired that came into our
possession um that it it would seem that the organization that brought that to us would have found asked upfront whether or not it's something that we could actually use and implement. And I don't
know if um if there's other counties that you know provide that service and and we learned how they handled it, but certainly if if I understood that that we had received that van given to us and then we're going what are we going to do
here? And if it means that we have to hire staff and insurance and all this kind of stuff, it might be something that we're not capable of doing. and whether Arrowhead Transit, you know, has an option or how we deal with this as
opposed to uh the situation that seems that we find ourselves in right now with with an asset that we can't use because there's costs associated. So that's my question. I think it's the challenging reality of
the just the the depth and breadth of turnover that we've had in our department in the past year that the staff who originally took on um conceptualizing the project and seeking funding for the project are none of them
are with the agency. and um we've had to really focus in on being able to provide the mandated services that we're required by statute to provide. Um and that's not to say that handicap accessible transportation is
not important. It absolutely is an important service to provide to the community. Um and it is a service that we are going to have to look at more closely as uh things stabilize within the department and we have the ability
to look at what it would take to fully operationalize boreal transit. I mean I think we will have to ask ourselves the question are we the entity that's best positioned to do this work or is there a partner such as you mentioned Arrowhead Transit that would be willing to take
that work on. Um, so I I fully recognize that that those are unanswered questions that are before us at this point. Um, and so this grant with MDOT was one small piece of a much bigger puzzle. Um,
and I think that's something that we'll be talking about more in the coming weeks and months. >> I appreciate the response. And I would add as well that in discussing this situation with Grace, rather than being out of compliance with the grant, um because we didn't believe we could meet
the deliverables of the grant within the time frame of the grant, we chose to back out of the grant so that we're still in good standing, reassess, like Grace mentioned to see if this is a viable service that we can provide, if there is someone else that can provide
this, and really do that analysis to make sure that this makes sense. for the county and figure out how we're going to strategically move forward instead of trying to piece meal it together by meeting the requirements of the grant but not having the policies,
practices, and procedures in place. So, I fully support this approach to make sure that we're >> really strategic about how we move forward. And again, like Grace said, um this is a service that is important and so it's not to minimize the need, but
really just make sure that we're doing this the best way that we can as we move forward. >> And I I guess that's foundational to my question is understanding all of the things that we're we're addressing now and and given the you know circumstance of which we found oursel I I think it's
an honest conversation and the response is is a good one. So thank you. Any other questions? All right, can move on to items for board action. The first one is inhome services cost sharing.
>> So, I'll turn this over to my colleagues Olivia and Plummen. >> You want me to start off? >> Okay. Is this on? >> You got >> Good morning. Nice to see you all. Hi. Uh, my name is Olivia Bonander. I'm the supervisor for adult and home and
community based services. I'm also covering for children and family services as well for supervision. Um, I'm also the designated manager for the 245D license that our agency holds. We're the only county in the state that holds a license like this. So, it's a little bit different. With that, we've
held a sliding fee scale for many, many years now. That has been based on income. It's been about $5 a month that we charge people for five five hours of services. Last year and the year before, we hit a point where the volume of requests for inhome support via the
sliding fee scale hit a point where it was really affecting the budget. We had to put a cap on accepting new applications for the sliding fee scale. So that's why we do hear I hear it out and why do you not have this anymore? I'm like it's not that we don't have it, it's that we had to put a pause while we re-evaluated financially how to make
this more viable. We are changing the name a so that it's less confusing. People get this confused with the sliding fee scale at the clinic with high frequency. We're adjusting the title to be a cost sharing program because that is what it is in nature. We are adjusting the cost sharing so that
it is a little bit more fiscally responsible um based on federal poverty guidelines having more of a tiered approach based on income. The higher income you have, the more that you'll pay in for that service. And if your medical assistance qualified, you'll maintain hopefully roughly around that
$5 a month. So, it's a change for those who make a little bit more money. It's not going to be as heavy of a burden for those who are already right at that level for federal poverty guidelines. We have that all built out and have updated the policy and procedure accordingly. We also have updated our application for
services as well to adjust for this change. The goal is then to bring some money back into the program to make it a little more viable because we still want to have this option for individuals who are under over the age of 60, not quite 65 and maybe don't meet that medical
assistance um income and asset limit yet. We're the whole point of the cost sharing is really to help people who are in that in between spot. I maybe don't meet level of care for needing a a waiver or I don't need to go to a nursing home yet, but I do need something. And so that's the point of
this cost sharing is to help fill a very much and it's growing. It's a growing gap for people who maybe just don't have not it's always this in between of whether I have too many resources or too little. This is meant to kind of fill that slot.
>> Any questions? >> Frank Olivia, please excuse my ignorance. What in home services do you provide? >> Sure. So the 245D license that we hold is for basic services. That is homemaking and chore services. That can be cleaning, cooking in the home,
helping with basic like helping pick up prescriptions. And chore services are a little bit more broad for this part of our program. It can be like shoveling your driveway or shoveling um along your path. Sometimes it's helping with wood carrying, bringing wood into the home
for individuals who get a cord dropped off. So it's really more practical trying to help people maintain at home. And you have the people to provide these services. >> We do. That's the exciting part. We do have a fairly viable pool of independent contractors. So, they're not necessarily
a county employee, but they go through a lot of background check. They have a supervisor. They go through annual training, and we monitor pretty closely the work that they do. >> Well, that's great. Um, >> it is. >> Thank you. >> Yes.
Jenny, Commissioner Stley. >> Hi. >> What is the age range? >> Ages 60 and above and also anyone who's certified disabled through Social Security or SMR, the state medical review team, which is a tier down from Social Security disability status. So, it's a really wide range of people who
utilize this program. >> Go ahead, Mr. Damble. >> Yeah, thank you, Mr. Chair. Thank you, Olivia, for the presentation. I would say that um uh we are aware that people as they age that living in the home that
they're familiar with is is part of what contributes to their sense of well-being. They feel safe. They're familiar with all of that. And uh in home care services is something that enables that to happen. So as people age and and they're wondering how they're going to be able to maintain their
residency in home care is a real gift. So >> it is that's why we're happy to try to provide and maintain this program as best we can while also being fiscally responsible at the same time. >> Can you give us an idea of the scope of the program is how many hours a week per
month are you providing to the people? >> That's a good question. So we have I think roughly 20 providers right now and they're providing I mean I sign the time sheets. It's like a stack this big every month. For some individuals it's upwards of 20 hours a week. For those on this
cost share program, it's 5 hours a month that they are allotted. And we also have private pay options. So people can hire these independent contractors and pay them privately, which we don't track as heavily because that's between that individ individual and the contractor. But I'd say on average for people who
are receiving this service, it might be anywhere from 2 to 10 hours a week. >> And roughly >> how many people? Uh maybe 50. >> Thank you. >> 55ish. We do have a bit of a waiting list. Go Pal. might know >> we have a waiting list. Okay. So, there's a waiting list.
>> There's usually a waiting list. Yes. >> Yeah. I mean, we have our list here that's been provided by our income support um coordinator. We have 30 clients right now. >> 30 by the program. I I just want to make sure that there is a good understanding. The home support um program provide
services to people who um are that qualify under other programs like the waiverss. And um so what we are asking here is just one portion of the of the clients receiving services who do not
qualify for those other programs to have cost share because they don't meet requirements for the >> Lin Can you clarify is that number 30 the people who are doing the cost share? >> Um no at the moment. >> Okay. >> The total amount of clients who receive
>> services by their home support program right now is 30. those who receive sliding fee skill are um I think it's also in the >> 22 >> and yeah >> and we do have a waiting list for individuals who are waiting for the cost
sharing to open back up >> okay >> because we had to put a cap while we figured out what makes the most sense moving forward >> so the waiting list is not because you don't have providers it's >> based on you don't have the cost share funding >> okay but it's both and I bet you like
the sliding scale waiting list is because we didn't have funding. But there is also a waiting list because there aren't enough providers or are there enough providers now? >> I will go like this. It's a bit of a teeter totter. Every day is a little different. Welcome
to social services. We the need is always higher than what we can provide. I'll just say that generally. But not everybody will apply for services knowing that hey, I heard in on the grapevine or from my neighbor that that you know there's no one available. So the availability really fluctuates and I
mean it's hard to hire and maintain staff in general but we are doing the best we can where we're at. >> Thank you. >> Also this is not a mandated service we are providing good service um because there is no other providers in the county. >> Y
>> but um and we feel like if we um share the cost with the recipients then we will have opportunity to provide that service to more recipients. >> Okay. Um, so that's the goal here is um not just simply to um offset the cost
but also to be able to provide services to uh more people. >> Yeah. >> Commissioner Gamble. >> Yeah. Yeah. Thank you. Um, so you mentioned that there there's training associated with this so that if if somebody listening to this and we're looking at people that might be
interested in being a provider that certainly providing a context to understand the nature of what you do and how we come alongside to equip you to do it. The hourly wage that is paid to inhome care providers is what presently
>> that is a question that has multiple layers to it. I was go ahead plumbing. >> What we're paying the providers is $7.90 for every 15 minutes of work. >> $30 an hour roughly. >> Roughly. >> Yeah. And so for people that are
listening say, "Well, $30 an hour. If if they are aware that they might, you know, be interested and then we we would interview and make a determination whether the individual's qualified and da da da da." >> Yep. You can call into our agency. It's a formal application process with a
background check requirement. We do on-site training, so physical training, hands-on, and we also do ongoing checks as well as annual trainings. It's pretty formal because we are a licensed service through the state of Minnesota. There are pretty strict requirements. >> Sure.
>> Also, I want to make it clear that what we're proposing here will have no effect on the rate that's being reimbured to the provider. What we're switching here is who pays the provider how much >> and we're increasing the recipient's
portion versus the future just >> Thank you. >> Um, Commissioner White, please. >> And does that include at least travel time one way? Like if you're going up the trail to help somebody, we do reimburse for travel time. There
are some rules to that, but yes, we do pay for travel. >> Minister in trouble. Just out of curiosity, how many independent contractors do we have? >> I believe I don't have my computer open. >> 14. >> Oh wow. >> But there's availability for more. We
have to hire based on need. And so that's why I say it's a bit of a teeter totter. When we know that the need rises, we put out for applicants. And when we have more applicants, we try to garner more individuals because that is a 1:1 ratio for contracting between them. Some of these providers have
upwards of 10 people that they work with. Others say, "I'm just doing part-time. I'm doing I'm going to work with two people." So, we really try to keep it as balanced as we can so that service need matches the ability to to render services. Great.
>> Any other questions? >> Any motions? >> Commissioner Sullivan. >> Mr. Chair, I'd like to make a motion to approve the 2026 inhome services cost sharing table. >> Thank you. We have a motion in support from Commissioner Gamble. Uh further
discussion >> hearing or seeing none. All those in favor? >> I. Those opposed. Motion passes unanimously. Thank you very much. And then this moves on to our uh 5B item
that I mentioned uh when we approve the agenda. I'll hand it to >> Sure. >> I can get this one started and then Kristen, if you want to chime in, we can uh work on this one together. So, this is an extension of the contract with
Birchbark Consulting. That's Megan Mo who's providing an assessment of our department that will be presented at the March PHS board meeting. And the reason for amending the contract was to um add
a component that's ongoing consultation and coaching to me as I uh implement the recommendations in Megan's report as well as to extend the end date to allow for that ongoing consultation with Megan.
And I would add that this is an additional um approximately an additional $5,000 that we're adding to the contract. Um like Grace mentioned for coaching and support for her. Um once we received the report, we have
received a draft report and it is around I think it's 57 pages if I'm not mistaken. So, make sure you block some time on your calendars before the next meeting uh to review that before um before she presents it. But it's very thorough. She has a number of
recommendations, some things that we're already implementing, but I think having her partner with Grace over the next year to help to ensure that we're successfully implementing those recommendations will be very helpful to us. And so, that's the reason that we
really want to move forward with it. >> Yeah. Any questions? Any motions? Commissioner Sullivan. >> Thank you, Mr. Chair. I'd like to make a motion to approve the contract amendment with Birchbark Consulting LLC. >> Thank you. We have a motion. Is there
support? >> I would I would support it enthusiastically. I think this is a a good connection. If if what we learn we we don't know how to apply it that uh we we missed an opportunity. So, this is this is great. A motion support. Any
further discussion? All those in favor? >> I. Those opposed. Motion passes unanimously. Thank you very much. Let's uh wrap on all that aside from our committee reports here now.
Starting with the active living steering committee. Commissioner White. >> Um yes. Essentially with the uh this committee um every agency or organization involved in building trails and um paths have
been impacted by a reduction in funding. Uh though they have not it has not dampened their enthusiasm especially on the west end when they talk about um making a safe pathway
along that highway and the seemingly insurmountable terrain but I got a sense that whatever was going to happen they were going to figure it out and make it work. So, I thought that was interesting. And my ne I'm next on the agenda with
the AEOA, which is the Arrowhead Economic Opportunities Agency, and they meet on Thursday of this month. And the Arrowhead Health Alliance Joint Powers, they are meeting next month.
>> Right. Um, we have our child care solutions subcommittee which was Commissioner Stley now I believe is Commissioner Gamble. I don't know if it's met. Okay. Um, moving on to the community health board. I gave a a brief summary
at our board meeting. Um uh just to recap that the the good doctor's uh conversation was around uh vaccines and vaccine rates and um D. Oh yeah, touche. Thank you.
Uh and but if Frank if there was anything else you wanted to add regarding the community health board. Um it talked about the measles vaccine and >> there there were a couple things. Um, one of them just a little bit um, more on the uh, on the vaccine
recommendations. Um, one of the significant things is that generally insurance companies pay on recommendations in Minnesota. They have been paying on Minnesota's recommendations based on the u professional associations the American Association of Obstitricians pediatrics
and so on. So, uh, even though they are not following CDC guidelines, they, um, the insurance company is still covering what the Minnesota recommends. Um, out of the, I believe, 17, um,
childhood recommended childhood vaccinations, that's been reduced to 11 at the CDC level. Um but we're continuing to maintain all of them including human HPV um which has been reduced from a guideline of three shots
to one shot. Okay. Uh but again in Minnesota we're following the full recommendations of the of the three. Um the other thing I wanted to and I have I have some more information if anybody
wants more particulars. Uh the other thing I would like to uh mention was that uh uh I have been chosen by the community health board as the alternate representative of the community health board to the Minnesota uh state uh got
to remember this name now. Uh >> Shaq, that's all I >> Shaq. Yeah, >> I can I can fill it in. It's the >> state community health services advisory council. I am the representative Shakan there. So I will be uh I guess also
reporting on what goes on at check at our quarterly meetings. >> That's most excellent. I really appreciate you stepping up there and >> being should be a different overview from the county level out to the four county level up onto the state level. Exactly. We'll see.
>> Yeah. No, that's awesome. Um Oh, shoot. Oh, yeah. And and one of the things I had talked about at a previous meeting uh just the regular board meeting was the the in particular the measles vaccine rates dropping but then where there are outbreaks them spiking.
Yeah. >> Um but Minnesota still is low as far as our vaccine rate especially for measles is concerned. I don't know about our county per se but >> I don't have the numbers pulled up right now. One thing that's challenging is um
sort of what the denominator is when you look at vaccination rates, but we we maybe we can do this at a future board presentation and I'll come with more data to back it up, but when you look at the rates, sometimes they'll look based on um grade level. So, if they're looking, for example, at kindergarten
MMR coverage, we're talking 40 kids. So the percentage can vary very widely with a denominator of 40. Um but there there is a concerning dip in vaccination coverage for measles through the MMR
vaccine. Um, and I know that our local schools, um, as when a person registers their child for school, they do need to send their immunization records. Um, and that the schools have been doing followup with families to ensure that if
there's a child enrolled that needs uh, update to their vaccination record that they're receiving outreach through um, the school or the school nurse. Um and that's uh we also have an ongoing collaboration between Andrea Tafty who is in addition to our emergency
preparedness coordinator, our uh infectious disease coordinator working with uh Sawtooth Mountain Clinic on projects related to um following our vaccination rates and creating specific
strategies to boost them when we see them lag. Um, the other thing I wanted to add, uh, was just regarding federal grants and the infrastructure grant, public health infrastructure grant. I'm getting emails. It was almost a playbyplay from
the CHB. Um, at this point, the CHB staff are are not affected. Um, but I guess there is some administrative costs that the CHB will have to carry. Um, and I think that was the latest email, but um, just wanted to give a heads up
there. >> Commissioner Mills, CHB >> Community Health Board. >> Okay, just >> Yeah, thank you. Um >> I believe one of one of those people whose funding would be affected is Jenna who I believe sits in the county even though
>> she Jenny uh Miss Patun and >> we do have um the ability to so the community health board is the joint powers entity that um state and federal grants often flow through for the 4ount
region of Carlton Cook Lake St. Louis. Um, and they also have staff that are based regionally that can support us locally on different projects. So they have two planners and a communications
specialist. And there is a portion of their funding that is covered through the CDC infrastructure fund. However, often in public health, we say we braid funding. So we're looking at when grants expire and trying to piece together
multiple grants that cover the same scope of work. So the staff based at the community health board um right now the funding isn't affected. However, going into the next state fiscal year, the intent had been to use this grant to
fund three positions on the regional level. So it could in the future be affected. It's something we'll just have to watch and see. And then uh I was about to my attention that I missed item 6D which is the Arrowhead regional corrections
>> meet Friday. >> Ah that's why I missed it. Um, moving on to G then is the Cook County Local Advisory Council for um, mental
health. And Rana, are you on the phone? >> Can you hear me? >> Yeah, but I'm going to turn it up here. Okay, now it's it's up to 11. >> Can you hear me now? Okay. No. Um, actually I don't have much of a
report because I didn't I didn't bring my paperwork with me. >> Oh, okay. >> Any any any overview is fine. Otherwise, uh, we can move on to >> Yeah, nothing major that I can think of. So, but thank you for including me. I appreciate that.
>> Yeah, appreciate you calling in here. >> Thank you. >> We'll move on to the Council on Aging, then Commissioner White. uh they met last week and uh last week went and it's just more of the same.
They're busy. They have uh uh a lot of people get picking up their meals and it's a financial crisis shortfall that they are dealing with. I mean they I'm sure they could spend down all of their
CDs and money markets, but that's not the way you run a good operation. So, um, they are still pursuing more grant opportunities. They did receive the 22,000 something from Northland Foundation to hire an administrative
assistant full-time. I mean, they had one halftime, now she's full-time. And, uh, it's uh, tight, but it's not bleak. It's very positive. Yeah. Commissioner White, has um the Council on Aging
looked to the Minneapolis St. Paul Foundation for any grants. >> We have the grant writer is looking at all of the different offerings that are out there for nonprofits. I mean, they put that our the last board chair started without the
experience of really knowing how to look for grants for nonprofits became it's a little overwhelming. So, the grant writer now is is searching out all funding, all means of funding that might be there for for uh >> You might want to ask and see.
>> I will ask specifically. >> Yeah, there they have grants up to $100,000 that are available. I believe um I don't know when those grants have to be in. I know it's it's early winter. So, um Okay. >> Might want to bring that one to their
attention. Okay. And then the next one is emergency preparedness committee commissioner Sullivan. >> Thank you Mr. Chair. Um, we had a great meeting last week and Andrea Tufty was unable to be with us, but Grace led us through a tabletop exercise where we
talked about warming shelters and there were two scenarios um kind of a shortterm maybe less than a day and then an overnight. And um it was a great activity in that um it caused me to really think about all the many things
that have to go into place when we do something like this. Um you think it's simple, somebody just calls that we're going to have it and it gets out on WTIP and it happens. Well, there are a lot of different things to consider. There's activation criteria. How long are we
going to be without power? Is it a short period of time? A long period of time? What are the temperatures outside? And um do the places where we consider opening a shelter have ADA accessibility?
Do they have a generator? And probably that generator question was was the the biggest thing to talk about um because backup generators really need to have um be in place and have enough fuel for you know several days potentially. So
anyway, we talked about just power and heat and safety, volunteers helping out, but also that we have staff from PHS which will um be working. We talked about food, water, um storage of medications that need to be
refrigerated, um communication plans, transportation, um documenting who comes and who is staying there. What else did I miss, Grace? Um, we talked a lot about coordination among the different entities that would
be working behind the scenes to coordinate opening a warming shelter and getting the word out to the broader community. That was quite a bit of the conversation as well. So, I think um it was really good to to talk about this. Um let's hope that in
the next day or two we aren't um activating this plan, but if we do, we've had a bit of practice with this tabletop and it involves, you know, planning for safety and warmth and basic needs and we know how harsh the conditions may be in the next couple of
days. So, I'm really glad we selected this particular tabletop and I want to thank Andrea Toy for uh planning this event. Commissioner White, >> um, was were the the West End with their, uh, emergency emergency shelter, are
they part of the plan? >> Are you part of the plan? >> They are. They there's a West End representation in the emergency preparedness group. Okay. >> Um, and so the West End group, they can call on the county for assistance or
they can, you know, operate largely independently. the offer is there, the connections are there. Um, and and so they were part of the tabletop exercise last week. >> And do you have a generator? >> Okay. >> It's taken us three years, but we got it
all put together now. >> Well, let's hope we don't have to test it tomorrow. >> I know testing is probably okay. >> Commissioner G. >> Yeah. Thank you. question I have if uh discussed u when
it comes to uh individuals that um are not aware of the provision um just read the other day with all the snowfall 95year-old woman you know and 118 inches of snow you know found under that 118
outside her door. So we probably have a number of individuals that might not be mindful of the provision that is in place which means neighborliness or >> people that are mindful but that that would be one element that should be discussed is how do we how do we make
sure that this service is and provision is available to people that might not you know have communication awareness contact or anything. So that's one of the elements and that's basically going to be people that are neighbors that are aware,
>> right? Absolutely. Andrea um led an initiative last year which we still have the materials from. Some of them are on our website, but there's also physical magnets that people can hang up in their house that give you the steps of how to prepare for a prolonged power outage,
which often goes handinhand with winter weather and storms. Um, we also have worked with care partners and their staff is also able to preemptively talk through with clients and older adults how to come up with a plan um before an
event happens. Um, but we in terms of communication, our primary channels are the radio and online, so either social media or our website. So recognizing that that
doesn't reach everyone, the alternate strategy is radio. And in that anticipatory guidance prior to an event happening, that checking on a neighbor portion of it is is a big part of the plan because even
if we are consistently online and on the radio, there still will be people who don't hear the message. And so neighbors checking in on one another remains a really important strategy to helping members of the community who might be
isolated and unable to travel to perhaps a shelter location. >> Thank you. >> And we did talk a great deal um about communication with the public. It's really nice that now WTIP is part of
this group and um Kirsten Wiznooki was there and um I feel like we have a really good partnership um with them >> and it all works well while the power is on. >> Get out your crank radios. >> I mean they they can get it out of the
station but people need to have a backup right >> battery radio or something. >> Correct. And that's one of the things we talked about with go bags back when we were looking at fire emergencies. Always having that radio with batteries, a
crank, solar, a variety of things to keep communication at the forefront. >> Frank, >> yeah, I I was actually kind of surprised um monitoring the upcoming weather that there was nothing at all about emergency shelters or anything like that. The problem is number one, yeah, once your
radio goes out, an announcement that emergency shelters are available over the radio really is not going to be very helpful to very many people. Um, and uh online social media even less. Do we have a functional reverse 911
system? And do we have a functional cell phone alert system? In other words, not a pull where I have to call somebody or go somewhere, but where messages will come to me. >> Yeah, code red.
>> We do code red, like Commissioner Sullivan mentioned. Um I should also mentioned that Mike um is planning on attending a webinar this afternoon at 3:00 about the upcoming weather and so as we have more information available um
we will share it via the channels that Grace has mentioned. Go ahead. >> I mean, and the biggest thing is check your neighbors. I mean, you know where they are. You know where they >> whether or not they like people. Yeah.
You know where they live. So, just check in to make certain. And then I think it's also that if something happens that they know that I don't know how they would get information out to say oops I think maybe I should leave. There might
be people that just the neighbors that could get you out. Maybe not happily. The the other thing is when the time comes and the power is out, that's because snow and wind are making
>> tree branches fall on power lines. Not the best time for an elderly person to hop in their car and drive to a center. Okay. So again, from my own personal activities experience, okay, so this is where we would get, you know, a page for the fire department and a person over
here is I don't know if that's set up. I don't I don't know would be, you know, the way that would normally work is that somebody would call 911 or call the police department and would say, uh, I'm cold. I I have no power. I'm cold. I I need help. Would
that be considered a trigger for a call to 911? And I would suspect that for many people it's not, even though it could be life. I would say um the non-emergency law enforcement number is the number that's typically used and
recommended and they do have a link to our after hours PHS on call social worker. So we've fielded those we work together with law enforcement in those situations to try to get people what they need. >> But what would they do?
>> They would call the non-emergency law enforcement number. >> No. No. So that so the non-emergency gets a call. Are they going to send the police cruiser? How many police cruisers are there up on? >> You know, I think it depends quite a bit on the situation. So, we've gotten calls in the past um for I mean, one of the
things with prolonged power outage and shelter is how many people are affected and if it's a situation where it's very few um you know, there's people who have multiple sources of heat in their house, but let's say it was only electric and there's a power outage and we know that
there's you know, but our um some people will go to family and friends houses, some people don't have that. So, if we get uh kind of a one-off call, we have helped with um hotel for some people if they don't have the means or the social
connections to have a place to stay because we have to weigh the cost of staffing and setting up a shelter versus helping in sort of a one-off situation. So, that's been something that social work staff have done, but it's a conversation, right? Because sometimes somebody just needs to be prompted, oh
yeah, actually I do have a friend. they have, you know, multiple heating sources. They live a mile away. Maybe my best bet is to reach out to them. So, it's it's a conversation and every situation is unique, but reaching out to the non non-emergency law enforcement line is one way to get help. And I would
add as well that if we are looking at opening the warming shelter, it would be a conversation between Mike Keeport, our emergency manager, the sheriff's office, PHS, um, and myself to make that determination to make sure that it's needed. Um, and like Grace said,
weighing all of the options. You know, is there a one-off need for a hotel or is there a larger, broader community need at that point where we need to open that up? Commissioner G. Thank you, Mr. Chair. I I think the important thing because we
can't cover everything, but it but it is uh being proactive and I think that's where the tabletop experience is important. There's a lot of things from a information standpoint that we can assimilate that unless we walk through some scenarios. Uh different
personalities respond differently to you know crisis and therefore walking through some of these things helps to broaden our response to need. So I I think you know Red River Valley have they ever had a flood come springtime.
uh and uh those experiences teach those that are entrusted with the responsibilities of the well-being of our community to anticipate and to look at things the best we can try to cover our bases in that regard. So that uh proactive approach is I think a strong
message to the community that we're thinking about it. We're we know our local area and we're trying to put in place things that can respond when need does arise. But it all boils down to human relationship really. And uh when
we are when we are neighbor neighborly and cultivate relationship in that regard, the best response is is people that know you and know your specific need and know the resources that can respond outside of what we can provide. So >> absolutely
>> excellent conversation. Uh the next item is the healthc care planning committee and last meeting we >> we're going to eliminate that. >> Yeah. So that committee has been sunsetted. Yeah. >> Um we're talking about really building
up provider representation on our PHS advisory council because there are there is significant crossover between those two groups. but just ensuring that all of our provider representatives are
invited and aware that their presence is welcomed at our advisory council. So, >> thank you. >> Uh, Northeast Minnesota Office of Job Training Program, Commissioner Gamble, any updates from that conversation on
>> bylaws or joint powers >> continues. We were going to determine the joint powers as as to requirement on that. So not yet. Okay. Thank you. Uh Nico, anything there? Commissioner SC. >> Okay. Yes, of course.
Um but I will just uh congratulate Frank for u going ahead to join Shaq. It was an organization that has been at least three four years in the shaping of it uh by a former commissioner who retired now Sheila Cascaden. and um we had a lot of
conversation about the parameters and what would be included and all of that. So you're the recipient of a well put together group >> and I am working my way through tons of documentation on what they've done and what we're doing and what's going on.
>> You will so uh national association over 3,000 counties. So, we have some briefs we put together for the um national organization in Washington DC. Um, I'll just mention basically there's a lot of
concern about mental health, substance abuse, Medicare, uh, federal, state, and partnership with Medicaid, um, local crisis response efforts, enhance funding for local rural health
programs, support rural emergency medical services, but we've added a new one. And that I'll just briefly summarize it because it's quite a few pages long, but
we are to urge our members of Congress to modernize the Medicaid institution for mental diseases. This was formed back um probably I would say they suggest it was actually talked
about 20 years ago and as a group we resurfaced it because of where we are now with mental um diseases. So basically it is um to have provide more services for mental health and
substance abuse disorders in treatment facilities um with more than 16 beds. >> So here in Minnesota duth I think is working on some facility
maybe is it a noa that has some facilities. So we don't have a whole lot here in Minnesota, but we are a group of about 35 people. So, we're taking this as a response to several people in the country who really feel that this is
important to um to bring to the surface because we have outdated limitations that prevent counties who provide the funding and the operation for this health system to meeting increasing
community needs. driving patients to emergency places or jails or leaving them with insufficient treatment. >> So, this was the last new one that we added to the discussion in Washington DC.
>> Thank you. >> Next item is the Northshore Collaborative. I think I updated at our meeting, but just to do it again. um uh was presented with like a spendown um budget because of the funds not coming
in from um local time study um grants or I guess I don't know what you call that but um the kind of the irony was that our current budget was actually spending down faster than the spendown
plan. Um, and these are grants that are provided. It's just for the Northshore, just uh, Lake County and Cook County, usually for for smaller um, organizations, not always. Um, really aiming at um, supporting kids and their
well-being um, in the aim of then kids growing into adults and healthy adults in the community. So, um, also got a report on a closure of a child care over in Finland, um, that we had funded a
fair amount. Um, so that was disappointing to hear, but um, it sounded like in that particular area or case, it had to do with just enrollment. Um, so I don't know what's up with that. Um but
um then moving on to um public health advisory council. Frank, >> I did not meet this one. >> No. Right. And then the next one is the county food access council. Um we did meet um talked about the the overlap
there with um Northwood's food project. Um the food access council is um been in discussions um around different grant opportunities and the needs of the
food shelf, the needs of Ruby's Pantry, the needs of our community and and in in regards to just food security and um and so Boreal Waters is a granting agency that Um, oh, it used to be the
Northshore Healthc Care Foundation and now it's >> Vital North is the new name. >> Vital North. They're going to be pursuing this grant um that's supposed to be a transformational uh uh a system transformational grant. It's over three
years, $100,000 each year. Um looking at a way to make uh food security more of a reality for more people in the county. And so one of I mean the food shelf has the um the super shelf model in place
now and there's been rave reviews and and uh success. There's there's a strong demand. Um one of the things they're saying is we need a larger space and um and won't the county do something about it? And um I I said that um that's a
good idea and that it seems like a very good thing to support. Ideally, we wouldn't need it because everyone has food security, but they don't. Um, but I just um planted the seed that as we talk about um the capital improvement plan um
and just what changes might happen with the recycle center budget shop or might not that potentially there could be room for um a larger um food shelf space if that building ever happens. and that's
years and years out. But that's kind of what they were also thinking is some something bigger like that. Um but uh that'll require a lot of planning, a lot of discussion and and that's that's a ways down the road and they they understood that but they're happy just
to hear hear the thought. So um anything else I want to share there? couple programs is the food RX I think I talked about is getting it's a pilot program with the clinic and getting prescriptions for food and there's 10
participants in this pilot program and we'll see how that goes. Um and then um you know the overlap with North food project is just getting more food fresh food whether it's gleaning or or just leftovers from the market to say the
food shelf or or people in need that that could really use it. I saw a hand. Frank, >> yes, thank you. Um, I wonder if the courthouse pop-up food shelf. Um, how well known that is. And I
was wondering uh if there could be a little sign or a little handout or a poster or flyer uh at the main food shelf, which most people know about when they go there, just let them know that there's a business hours popup food shelf, walk in
anytime, no registration, available in the courthouse lobby. >> That's a great idea. >> Let them know. Yeah, >> I can ask Christina because she's the facilitator for the uh food access council and she's also done the promotions for the popup. So, I can ask if there's something that's already in
place. >> Thank you. Yeah, it's a great idea. >> And I would just add that the donations are not as robust as they once were at the popup food shelf. So, just um again notifying the community that if you have
food that you would like to donate >> that you can drop it off during business hours at the courthouse at any time. >> Um and those who are in need of food, you can like you mentioned, you can come and pick up food at any time during business hours Monday through Friday. >> I wonder if WTIP would be willing to
excuse me would be willing to just run a couple of PSAs on that. >> They have in the past. Um, and we can certainly include this in additional updates as we move forward with them. >> It's the Swiss cheese. It's a Swiss cheese approach, you know, and just because they run it three times doesn't mean that the people who know it have
heard it. >> Commissioner G. >> Yeah. Thank you, Mr. Chair. On on that topic, um, many of us recall that uh, with tourism, every community had their separate tourism association or it wasn't an
association, it was a tourist group. And um then they combined that effort into one voice. And I think when we look in at a community at this food issue, we've got multiple voices. And it would be
good to step back and look at this as something that is is stronger because of the association in working together. And um if if we do that and we look at it, we can find out and this can be true
through focus groups with different demographics um how we best address that need at these different levels and then put together something that says if you're in need of resource relative to, you know, food, here's the resources that we
provide as a county. but have it have it be something that is is organized in a way that's more effective than multiple that that we got to keep afloat kind of thing. I think that would be advice. >> I would say that's that's really the purpose for the food access council.
It's a place where all of the different entities working on food security are meeting every month and some of that material has come out of that group. So at the popup as you step out of this room you can see that guide for what the resources are.
>> Um so there is some work being done to try to streamline communications and understand what people's needs and experiences are. >> So that's a real positive thing coming out of that group. >> Yeah. The University of Minnesota, I think, mentioned in our extension
meeting, was talking about this, you know, with the the food RX and u uh just local food and uh there's food and there's food and and part of it is is understanding um how we
communicate the importance of fresh food, local food. And um this is something I think with Ruby's Pantry that if there's any way we can encourage so that there's a screening that is done because it's not just stuff that's in
bags that you can eat. It's what's actually going to contribute to your sense of well-being and your health which food is a huge portion of that. And there are representatives from Rubies who attend the food access council and are very well aware of some
of the challenges with, you know, choice and what's available through Rubies and are really working actively to try to see if there's different uh different options available for sourcing food. >> That's good to know. >> Yeah,
>> it's a really really good conversation. >> Yeah, it's a really motivated group of people. It's a great >> It was I think there was some frustration early on. At least I've heard feedback of frustrations early on just about forming. You know, that's always hard to start something and work through, okay, what's what's our bylaws
or how what's our structure and that kind. So, there's some frustration there. But, um, since then, I feel like there's been so much good information sharing and and uh coordination or just awareness. And so, things I think are coagulating and is that the right word?
>> Okay. Any uh any other thoughts else? Uh there's last for the good of the order else we're done. Okay. Thank you. >> Thank you. Thank you. >> You need a
few more seconds. >> I know. Okay. had a lot of discussion that is sort of uh on on the surface but what is underlying that is foundational that
>> is really really important in structuring how you address that talk about it from a sense >> here do you know there's >> one particular category that's not why
don't you articulated. That's what I'm trying to speak in if we understand. I mean, maybe understand because >> Oh, sure. Like toilet paper, tampons, soaps. >> Yeah. But but I know it kind of comes
and goes ways, but I think Grace has read what which things >> cuz I'm going to the grocery store maybe. >> Yeah. >> Before I have another meeting >> before it snows you better. Uh, hey, I have milk, eggs, bread, and toilet
paper. We're good. >> Yeah. What else do you need? >> There's enough other stuff.