Erica, >> they're always off time. >> 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, August 19th at 8:31. Um,
first item is the approval of consent agenda, which includes our meeting agenda, uh, minutes, financial reports, abstracts, and bills, uh, service agreement with the University of Wisconsin Superior for a mobile crisis response needs assessment. Is there any
changes to the agenda or any item a commissioner would like to pull from the consent? Commissioner White, >> I would like to have further discussion for the public about the needs assessment or contract. >> Well, um >> to have that at some point. >> Yeah, we'll put um let's see, we'll move
item 2E down to say 4 A. If that's okay for directors, we'll let handle that or >> or um hand it off. Uh any other changes? Then I would entertain a motion, please.
>> Mr. Chair, I'd like to make a motion to approve items A through D in our consent agenda. >> Support. >> Thank you. We have a motion and support. Any further discussion? >> Hearing or seeing none. All in favor? >> I opposed. >> Motion passes unanimously. Thank you.
Well, that moves us down to our staff report and I'll pass it over to Plum. Good morning, Bobby. >> Good morning, Chair Mills. Good morning, commissioners um um and staff and others present. I'm going to be presenting the
preliminary 2026 public health and human services budget. The Cook County Public Health and Human Services is integrated agency with three main departments. social services, economic assistance, and public health.
The budget was prepared in alignment with our agency mission and mandates. You should all have a copy of the detailed budget um in your board packet. So, please interrupt me and um if you have any questions, I'm going to be
going through the slides and pause after each slide for questions. and I'll be multitasking, switching my my computer slides with notes with the with the presentation. Now, the 20 the 2026 public health and
human services preliminary budget has a net county cost of 3,123,977 or an increase of 3.7% from the net county cost in 2025. This represents the difference between the budgetary expenditures and
anticipated outside funding or the revenue. The 2026 levy request is 27.8% higher than an approved levy for 2025 and this is due to no use of fund
balance in year 2026. As a reminder, $566,645 were used. Use a fund balance was budgeted in year 2025. Our proposed budget costs are 8.57% higher than last year. But with
increased collections, mainly under the social services department, our 2026 net county cost is budgeted 3.75% more than the net county cost of year 2025. Again, due to no use of fund balance,
the requested levy is 27.8% 8% higher than approved one for 2025. The preliminary budget for year 2026 includes no additional fulltime equivalents, reduction in hours for one public health
educator from 40 hours a week to 20 hours a week and reduction in hours for economic assistant case aid from 40 hours a week to 32 hours a week. Any questions so far? Next slide represents the organizational
chart as of u August um of this year. Um we provide services and it takes many educated and extremely dedicated staff to fulfill our state mission. Here's the PHS staff organization chart as of
August of this year. The social services department, the three columns from the left, the adult and home and community based services team supports the supports the elderly, developmentally disabled and vulnerable populations. The children and family services team
includes uh work with child protection, parent support and early prevention interventions. The behavioral health team provides children and adult mental health case management, substance use disorder services, and crisis response.
The public health department, the fourth column from the left, who partner with several local agencies to keeps us all safe, informed, and healthy. The economic assistant department. The fifth column from the left providing elig eligibility determination for financial and food support programs
funed by the state and federal agencies as well as healthc care programs. And administrative team at the top beginning with our director and along the far right column is our administrative team supporting all three departments of the agency including
leadership, office support and fiscal compliance. Excuse me. >> Yes, pl. I'm sorry if we can go back one slide to the actual to the budget. Yeah. Uh I'm actually I'm looking at the
insert which goes into a little bit more detail. I'm probably reading this long wrong wrong, but the first section, economic assistance, the way I read it, we're spending about $900,000
to give out about $300,000 in assistance. $900,000 administrative costs. Again, I'm sure I'm reading it wrong, but can you explain what's going on there? I'm trying to follow the
>> Okay. Personnel, which I assume means administrative costs, salaries, is $900,000. And those personnel, their job is to give out $300,000 in economic assistance.
Again, I'm sure I'm wrong. >> Yeah, I need >> I need some kind of clarification. >> I need to see the line item that you're looking at. I'm not able to see First red line this one. Yeah. >> Okay. This is the year to date. Um
>> No, this this is year to date. This is the budget. >> This is the 2025's year to date though. >> Okay. 2025. >> Okay. Let me look it up. I was I was on the budget for 2026. I guess switch here to year to date.
So, um, you're asking regarding the personnel expense in the budget for 2025, correct? So, $897,000 >> of personnel expenses. >> Yeah. >> And on a collection site, we have 417,000
under the same line item. This is based on a federal administrative aid we receive from the federal government to the state of Minnesota. >> Okay. >> And it's a percentage of the expenditures that we report >> through our quarterly reporting. I >> I wasn't questioning that. >> Yeah.
>> I wasn't going across, I'm going down. >> Okay. And so the client programs, those client programs are related to healthc care access, those are that are paid directly from our county and not from the state of Minnesota. Okay.
>> Yeah. >> Those include transportation, medical transportation, and cost effective insurance. >> Okay. >> Okay. Those services are almost 100 they they should be 100% reimburseable. >> Okay. Okay.
>> And it's only of the timing of when we received the revenue, >> okay, >> is that we might see some slight differences. >> Okay. >> But the the economic assistance teams administers many other programs that are not directly paid by the county itself, but instead they are paid by the federal
and the state uh funds. >> Okay. >> Once approved by our economic assistance team. >> Okay. I I get that. I'm not questioning the value of the services or or or the programs. >> I'm sorry. I guess I'm not understanding your question.
>> My question was for every $1 in program, were paying $3 in administration to administer that $1 of programs. >> Where did he get that? >> Right. So, I have if we could clarify um specific uh uh so we're on page two of
um the the um >> packet. >> The packet. Thank you. of the 2026 PHHS budget, I believe. And you're looking at um line item six, I believe. Correct. >> No, I'm looking at the very fir under
economic assistance. The very first line item personnel. >> That's line six. >> That's line six. >> Oh, that Okay. I don't have line numbers on mine. >> Okay. >> Um Okay. Yeah. 897,000.
>> Okay. And you're comparing that to which line? >> So, so that's the cost, part of the cost of administering this program. And this program consists of >> giving out funds. >> Mhm.
>> Totally about $300,000. >> And you're getting that from the lines. >> So, the next two lines added together roughly in round numbers, $300,000. >> The next two lines. Maybe we're on different pages here. I I believe Mr. S
is looking at the year to date for 2025 document. >> Let's do this so you can see >> which is the this item 2C monthly monthly report for 2025 July. >> Mr. Chair,
>> please. So I think frankly I'm sorry you got multiple things there but I I I think your question basically your question because there's a lot of >> data here but is it when you look at it you're just saying that
>> if we invest this much money in this program to operate it and this is what you know we're distributing the difference between what it cost us for what we're doing. How do we justify that?
>> And that that is the that's the core question when you're when you're looking at it. >> Well, again, those are the economic assistance team is doing mandated um um eligibility uh determination and the expenses you see are expenses
that are coming from our from the Cook County budget. They related to cost effective insurance and the child care um I'm sorry the child support contract with Carlton County which we also are required to provide. However, the
economic assistance team um um determines eligibility for many programs that uh funding is not coming directly from our local government. it's coming from Medicaid and from um from the state
and not federal funds. >> And Mr. Chair, I think I think overall when we look at each department, but looking specifically now public health human services and the umbrella of all of those different things that are reflected in the budget here. If we
understand what is mandated as to what we are required to deliver by way of services and we look at the funding sources that accompany those and there are many mandates that are unfunded and so then the county has to make a conscious decision as to you know
how we're going to proceed given the fact that it's all based upon levy or anything that we could generate in grants that is similarly related. I'll give an example that Milwaukee County 80% of their budget is is mandated and
if if we look at our in Wisconsin if we look at our budget and understand departmentally what p or how many of our services are mandated what is the funding source for that and at what is the level that we want to fulfill that mandate that is
going to be a burden that affects our levy and and I think that that that examination I'll use that word is is a healthy discipline when we approach budget is understanding
mandate what do we have to do what do we choose to do based upon what we have financially and the burden we want to put on taxpayers to deliver services at that level and we're challenged as every other entity certainly in in
county government with trying to provide more services based upon demand and expectation with fewer tax dollars. That is a challenge, but that is the fiscal stewardship that we're entrusted with as decision makers. And that's why
wrestling with budgets, we need to demonstrate that we build that integrity into the process. So, but I I think your question basically is just gee when I look at this, we're spending this much for this and it's a return on investment and how is that justified and
understanding that is part of that going through this process >> for the economic assistance team in question all the programs that they administer are mandated and required. >> Yeah. And can I jump in? >> And I think to your point, having some
understanding about this line item and what intern or what county funded programs are included and what federally mandated programs are included um may be helpful in the future as well is >> okay. And just just for reference for
those who are having trouble following along, I'm not using their computerized spreadsheet. I'm looking at the paper handout. in fact printed out the >> the attachments to the to the agenda and this is on page 15 of 41. >> Ah thank you
>> page 15 to 41 and it's I was simply questioning the upper leftand corner under budget the first three items but that's as far as I think we can go with it this morning >> and I I hear I hear your point. I was
just trying to follow with the numbers what numbers are. Page 15 of 41. >> Yeah. Thank you. And um and and I think your point is well taken and I think Commissioner Gamble, you eloquently um
summarize kind of the the meta too of of what we're trying to what we're trying to do and figure out here too. I think if if we were in a like uh committee of the whole or whatever, but when when we can have a discussion that helps us to
understand if you look at this under economic assistance and you say what percentage of these things and you understand what we're talking about on these things because sometimes the umbrella language is is not clear as to what's the nature of the service
provided under that umbrella. But if we look at the service and we say this is mandated by state da da da da da da da and the state has given us this percentage of revenues along with that mandate or this is an unfunded mandate
and so in order for us to be able to provide this service by mandate at this level it cost us this much money and then we see what are we getting for what are we spending and what do we have by way of control and budgeting process to
manage those dollars. So this is this is certainly a lot of detail and I would just make an overall statement that that where we are in the budget process as well as where we are
within public health human services this is this is a challenging task and and it's this u discussion is certainly in the context of undering understanding where we are
>> because um we're coming alongside um to partner in helping us to be able to deal with a very challenging thing. So this is by no means directed at individuals. It is saying we've got this
challenge before us and we're going to do the best that we can to help staff in but we need to be informed so that questions that come up like Frank Frank asks or any one of us that we're clear in our response and affirming what
you're doing. administrator trouble. >> And if I may add, um, we are aware that there will be additional mandates into the into the next years ahead due to changes at the federal level. And so I think having some discussions at the
committee of the whole um during this uh board meeting as well about those changes may answer some of um the questions that we've discussed here today as well. >> Thank you. Thank you, Frank. Oh, Commissioner Sullivan. Um, and just for the the
listening public, um, when we're referencing page 15, that is the monthly report for 2025, not the budget that's on the screen that people may be watching for the 2026 budget.
>> Thank you. >> Okay. Thank you, Plum. You said we could ask questions. Good answer. On the next slide, um this presents the 2026 budget impacts. Um since we have people providing
services per always always has the biggest impact on our budget the 2026 personnel cost include 2.75% cola increase and projected 10% increase in health insurance total of 19 positions were reclassified
in year 2025 the director from grade 240 to 250. Four economic assistance eligibility specialists from grade 150 to 160. 13 social workers from grade 170 to 180.
One social services in home support co coordinator from grade 170 to 180. Staff turnover in various positions in 2025 is resulting in lower projected payroll cost but also will likely um result in increased training and travel
cost. Client travel, client related travel costs are higher than previous years and these required visits that are mandated by the state and the federal law. In the last several years, we received COVID related grants in the public
health and allocated ARPA funding to emergency response and recovery staff and services in public health. Those funds are no longer available. DHS has not finalized all funding allocations for 2026.
Therefore, some anticipated revenues are budgeted using prior year averages. Some allocation amounts have been reduced like um one example is the adult mental health TCM rates while others
have been increased. Um the children's mental health TCMS and the child welfare TCM. TCM stands for targeted case management. Those rates have seen an increase. the DHS mobile crisis response
grant that is a required service in the state of Minnesota by counties and this is resulting in increased expenditures due to electronic health record implementation and contractor cost for clinical supervision and after hour coverage but
that also um is all reimbursible um expense and it's coming from the grant we have with department of humanities So all expenditures are offset by Dr. >> Mr. Chair. Oh,
>> please. >> Yeah. Uh Clayman, when I when I look at the accompanying documents, uh and I look at this slide that you just went over here and you have training and travel costs and it defines it as requiring visits required visits to
clients who reside outside of the county. When I look at the documents and I see like under economic assistance, our staining our staff training and travel is up 149%. And under social services, our staff training is up 133%.
When I look at look at that as a line item and I'm seeing staff training, we look at other departments, usually that means that it it's continuing education, it's attending conventions, it it's those kinds of things. I think it's confusing if under staff training when
the generic understanding of those line items means one thing but your explanation says that it is actually visiting to clients. So I just want clarification on that because when I look at that number in a in a year when we're trying to maintain budget I would
not like to see increases over 100% in the area of staff training and travel which is normally understood to be continuing education and attending conventions. Does that make sense? >> It in Yes, it does. It includes both. We are we do have some required trainings
that staff needs to attend but we also have um um an increased waiver load. We have um people still coming in into waiverss being eligible for waiverss which requires our staff to do a monthly
visit with those clients as a as a required um I as a requirement to for their waiver to remain in place. So it includes both continuing education, includes travel to visit clients, but
also includes um training and travel for new staff too, which we anticipate we're um likely to have this year. >> Yeah, >> it'd be my recommendation that we break that out. It would be like out of home costs. when we look at out of home costs
which fluctuates considerably that we understand that in the context of what that expense applies to and in this case if we have a line item that reflects how much we're spending because we need to travel to clients that's one thing and
we can understand it in that context when it comes to continuing education or con conventions or whatever else that we might have that should be a separate line item in my mind because we understand that clearly. >> Um, Commissioner Commissioner Gamble,
could you also um you mentioned the over 100% just let help me um follow with which line? >> Okay. If you if you look at under economic assistance >> on page 38,
page 18 is say under personnel staff training and travel. If you look at >> is it so this is I'm sorry to interrupt is this is um under the financial report is that right? >> Yeah. Expenditures page page 18.
>> There's there's a little confusion because in our consent agenda there's the monthly report which I believe Frank was referencing. Is that >> also are you referencing the 2026 PH budget preliminary?
Well, I'm I'm under the impression that this is the 2026 because it says 2025 budget. If you're looking at a page 18, it'll have your figure for 2025 budget and then it has the 2026 budget to the
right in that column. So what we see is we see that that staff training and travel line item in 2025 was $2,654 and it's projected to be 6,626 which is 149%
increase. And so when you go to the one that would be on page 20, which is under social services, you will see that that line item for staff travel is going from 36 to 85,000.
>> Thank you. uh uh administrator Treble and then Commissioner Sullivan um or Commissioner Sullivan, you had >> I was just going I was just going to point out for um the public that um some of the confusion on page numbers is
because there was an additional item item E added. And so if you printed this out before it, the page numbers don't match. >> That's just another little thing to add. At least we're talking apples to oranges
here. Comment, please. >> I would like to provide a clarification. >> The document you're seeing is a condensed version of my spreadsheet. >> So, let's go back to economic assistance for a moment. I want to make it clear
that for economic assistance, it does not include client related travel. This is only based on one travel for a conference to four of the eligibility specialists. So they can stay up to date once a year while the
supervisor remains and covers here. >> So that's the >> when it comes to the social services side of things when you're looking at um the trouble client related trouble that is um here let's take a look for a moment here. The client related trouble
remains fairly um it's the same number as last year. When you're looking at the $85,000 number, that includes the following. It includes travel for trainings and meetings for 22,651
and uh the electronic health record that is uh uh needed for the social services side which is the case works plus the expense for the electronic health record
needed for a SUD program and the mobile crisis response. So between the two that is combined of $62,000 a year. That 60,000 62,000 has nothing to do with the trouble but it has to do with the cost of the
electronic health record and the um data management um software. >> That's new. >> That's helpful. >> The increase we see is the travel training and meetings is increased of 42%. And that is a three-year average
that I've taken from years from the actual so 2022, 2023 and 2024 with the mindset I leave that number higher like that because I knew that we having staff vacancies in many positions and I felt
comfortable that that is um while it's 42% higher in the last year's budget it seemed appropriate to include because we have a lot of staff that's not that a lot of positions that open. >> Mhm. >> Um, administrator treble. >> So, Plowman um mentioned the two things
I was going to mention that we could separate out the program or client related versus the non um client or program related costs which he just walked you through. And then I also just wanted to reiterate what Plowman said about the cost for travel for new staff
and training. um that will continue as we onboard um new staff because we need to be able to provide them the training to be successful in their positions. And so that's typical that you see those increases during a time where you have um openings and significant staff
turnover. >> Thank Commissioner Gamble. >> Yeah, and that would that would be understood because of our our commitment to equip those that serve. So we we want that training and thing. I I would say in your explanation we would look at
this figure and the $80 some thousand here and the and the difference and then there are a lot of things that you you referred to that I would just say normally intuitively when you look at that line item and how you defined it you wouldn't find those under that and
and I think that helping us to really understand the budget it is best to break things out if we find that we encounter something new that we haven't had in previous budgets, if it requires a new line item, I would recommend we do that as opposed to finding a place to
park it because if it it adds to confusion in understanding budget. So, um that that's just an an observation. I would rather see it broke out so that normal understanding of what that line
item represents that intuitively we can apply that understanding when we examine budgets. >> Yeah. Especially when it's three times more than the previous line item when the new item is is like so overwhelming
a part of the old line item. And and I would just say as a as a generic statement overall when it comes to budgets that the less the narrative it's an indication of the better we've done in making sure that what we are
representing is clearly understood. If budgets require a lot of narrative then it means that it is more complicated. So I've always maintained that if we can make sure that our line items represent and are understood in a generic context
what that term normally means then people can understand it. If not and they ask the questions it's because it then it requires a lot of narrative and it it's best if we can try to represent them in a way that intuitively understand them and if it requires narrative then link that narrative to
explain why the difference. >> Mr. Chair, >> please. >> I would like to throw out a smidge of encouragement. When I go to AMC and attend the health committee meetings, we've talked about training for years. And we say when you have all new
trainees, they can't always go to Duth or Minneapolis or St. Paul. Please do things online. >> And I've encouraged AMC to support that. They're supporting us. Look at all the things, webinars, and all the things that we can attend. So now we need to
get it down to more of an employee type thing which of course that would come from you know the health and human services department as such. So in um September when we're in Alexandria, I'll go ahead and still keep saying let's get
this training so that people don't have to travel so far. >> Mhm. >> And um after two or three years, maybe they'll get the and I don't know has that in has that improved any where you don't have to do so much travel for new employees.
What I've seen is that after co there was a big shift in online trainings and now I'll take the state of Minnesota for example asking people to come back to work in in person because it has a lot of negative impact on
hotels and people are starting to realize that and starting to be in person trainings in person um seminars webinars not webinars but um Yeah, >> because they're seeing that it has negative impact on their local community
when they're not having people coming from the outside of the county and bringing money. >> Interesting. >> So, um I am all in favor of having when there is an online version um to have that training completed online rather than in person, but that's not always an
option. >> There's always more to the story. I know. >> Back to Commissioner Camp. >> Yeah. Thank you, Mr. Chair. I I appreciate that insight that you provided. What what I would say that our our focus is is in training. I think that there is and we have this
discussion I'm sure as commissioners and number of boards that we sit on about the personal um being present and uh when you're starting in a position new that the the training is one aspect of it but the camaraderie and the
interaction that comes from personal uh contact is hugely important so I wouldn't discount that but when I look at what our objective is to equip the staff. I look at in that context of the camaraderie, building relationships, and
then it's it's like what I learn is enhanced because of the context or the venue or the environment that I find myself in. I would say that that because we're finding the state is finding that there's a fall off in revenue from hotels and restaurants. That's the last
thing I would be looking at. >> Yeah. Really? >> Yeah. Yeah. I wouldn't I wouldn't my driver in decision-m and forcing people to do things would not be based upon loss of economic impact that affects here when it's affecting us locally of the taxpayer because it increases that
budget but missing the personal when I evaluate how we want to equip our people that's a huge element so I wouldn't discount that >> pl let's have a discussion offline because my work at CDC for years had to do with with training
the state and local workforces and there's a huge huge amount of resources CDC trained public health foundation um public health regional training centers uh that offers all kinds of training um
online and free and some of it may be applicable to what especially your new employees need. >> Thank you. >> We can we can talk about that offline. >> Thank you. Each year we thoughtfully budget for
potential out of home placement cost and while we are prudent with our budget we cannot precisely forecast the needs of the community next year nor how many children and adults may need temporary placement. In year 2025, the current year, the budget reflected a two-step approach to addressing these
potential expenditures. Increase the budgeted amounts for children out of home placement cost based on a three-year average. Decrease in the budget amount for adult mental health out of placement to return to two-year average from 2021 to 2022.
and contingency for using up to 200,000 of fund balance if needed in a social services for children's out of home placement children's mental health services and adult mental health placement in year 2026 I propose no use of fund balance and increase the out of
home placement based on a three-year average in increase to the children's mental health placement to the 2024 actual amount and increase adult mental health expenditures from 50,000 to 100,000 to better reflect the increased adult
mental health cost over the last three years. And when I'm saying that I'm proposing no use of fun balance, I'm going to switch to the next slide so I can explain. Okay, thank you. >> Um,
so actually it's going to be the slide after that. But this what this shows is that the levy um approved levy was reduced the net county cost was reduced to the
approved levy by uh 656,000 in year 2023 566,000 in year 2024 and another 566,000 in in the current year. That's a total of $1.79
million use of fund balance of budgeted use of fund balance over the last two years. Intentionally >> we've reduced our fund balance because at some point was um more in the budget for the uh following years. So we felt
like rather than asking for levy money, we were comfortable reducing the um impact to the levy by using fund balance. Now in 2026, this next slide
will show that the actual PHS fund balance in the at the end of year 2024 was 3,39,216, but from that there was some restricted funds that could only be used for certain reasons.
So that left um uh 3,282,72 available. In the year 2025, we budgeted 200,000 for our home placements under social
services department and 366,645 under a child care subsidies program from wage enhancement. So the projected balance at the end of this year is 2,715,427. That is if all the revenues and all expenditures
are exactly as we budgeted them. So um the so the county fiscal policy requires PHS to have a fund balance of at least 42%. And that is because we don't receive our
first tax allocation until usually May which is the fifth month divided by 12. So um when we when we consider that we have to retain two 2,580,753 of um fund balance which is which
represents 42% of the budgeted expenditures for year 2026. That only leaves us with 34,675 of fund balance available to spend. It would be my recommendation to the board
that we leave that balance and not use it in the year 2026. We have some changes coming from the federal and state government that we're still trying to determine. Graceful Grace Granagar, our public health educator, will have a presentation in September during the joint um um public
health and human services advisory council and adult and a mental health advisory council meeting uh in trying to provide some detail of what those what kind of impact those changes will have. Um so um my
recommendation at this time is to not spend fund balance in year not budget for fund balance in year 2026 based on um um those numbers presented. >> Commissioner Campbell.
>> Yeah. Thank you, Mr. Chair. I would say in in looking at budgets that um if we just take a family that that a family can see how shifts in their
budget on the income and expense side if they have increased insurance costs, if they have increased electrical costs, if they have increased whatever. And then you look at your income. If we in our population out of the 87 counties have a population that is higher in retirees
than any other of the 87 counties 86 in the state then our awareness is that depending upon how their shift in their social security benefit is when they come to budget they look at and say okay here's my income if I'm not getting an
increase in social security or it's very minimal which has been consistently uh and and up until the last couple years that uh they have to make a decision to say if we're going to continue to live life at the level that we live it at, we're going to have to
dip into our savings, which is equivalent to our fund balance. So when we're looking at it, we have three options. Well, we look at multiple lines. One is our income. One is any increase in mandated services without
funding. And that's the expense side of things. And the other is what do we have in savings? And to the extent that we can protect our savings, if it's mandated that we need to be at 42% of budget, then we have no recourse. We just have to stay there. And your
analysis here shows us that we have 13,000 over. But we're saying given the uncertainty of things, we want to keep that there, which is the same as the family's saying, we don't know what the rainy day is going to bring. So I'd hate to touch our savings here, but we're
going to have to manage our income and expense. And so this is where I think the challenge is departmentally is to try to be the best stewards we can in in controlling costs so that we can maintain that 42% and yet not put that
burden on the levy that impacts people that are struggling and maybe have tapped out their savings and can't keep 42% of it because of increased costs. So it's just a it's just a a generic thing relative to budgeting is
we have these options and if you want to protect the 42% we can't do that on the backs of taxpayers unless we can demonstrate that we have no recourse and that means managing budgets fiscally so that we
don't add costs that become a burden to the people that have to fund this. I mean I think we're we're all aware of that it just how do we get there and that's through disciplines and through the course that I that I took on budgeting that matters you know with uh
no this whole evidence-based this data driven this communitydriven thing that is the partnership we want to create so that we we all share this burden and responsibility and opportunity we have to deliver services at a level that we
can afford that is substantiated backed up by the evidence of the process that we go through in arriving at our final figures. So, >> thank you, Administrator Treble.
>> Thank you um for your comments, Commissioner, and I agree that I think we need to always be looking at uh looking for ways to enhance operational efficiency and that we're managing the funds appropriately. I do need to add
that I attended a webinar this last week about changes that will be coming um from the federal government and um and one of the things that they mentioned is this will have an increased cost for counties as we move forward. So I'm trying to make sure that we're gathering
information about what those changes will look like for us. But I I do want to make note that um we will be asked to do more with less as we move forward. And so that's something that we need to be mindful of as well. >> Thank you.
Please. And for the record, I take um stewardship of funds um as my number one priority. And um the bud the year of 2024 finished under budget um uh because I have been
uh very careful of how we spend money and um I've been providing regular um summaries to our director Allison McIntyre at the time of all the expenditures monthly and where the points um of the increased um
expenditures were and I have worked tirelessly with our fiscal team to improve revenues so we can offset the expenditures. Um do we have a lot of work to do? I know that I I realize that but it is not um we're trying really
hard to increase revenues while we are really watching the expenditures carefully. So I want to make sure that that's clear. >> Thank you. >> Thank you. >> Yeah. Uh just additional context if I may. um our previous use of fund balance
for um auto home placements as well as the child care subsidy are are both very intentional um to spend down our fund balance because rather than putting it on the levy um also the you know the out of home placement is kind of our
worst case scenario. Uh so we really tried to invest in staff to get ahead of that. Um at least that's that was our attempt and our hope. Um and I think we've done a great job at doing that. However, costs have still fallen on us. Um and then as far as the childcare
subsidy is concerned is a very similar tact there um to try to really invest in our in our youth and our our youngest. Um and you know that return is a much longer term return. But but again that
was a strategy and and intentional. But now when uh we knew the fund balance would not last forever and that um at some point we were going to have to shift um then uh here we are. So
it's still my goal to increase the fund balance to a comfortable level and continue to reduce um the impact of the levy by using fund balance. And again that um will that will be only possible if we watch our
expenditures and increase our revenues. And I'm well aware of um of that. So and we're working hard with our team to um towards that goal. >> Thank you. >> And bravo from from the previous years. Yeah. under revenues u opportunities.
We still continue to utilize the substance misuses suicide prevention grant which is funding one full-time equivalent position. We also have uh other public health grants available to
use which are making impact to the community while um offsetting um staff and other cost. Those are age friendly communities grant, cannabis education funding, um the public health emergency
preparedness and the CDC infrastructure grant response sustainability grant, healthy housing grant and the DHS mobile crisis response grant as well. >> Commissioner Gamble. Yeah. U I just
noted under the social services revenue when you're referencing these revenues that there's the uh mobile crisis response federal aid and according to what I'm looking at and I won't get the page number cuz who knows what it's going to be. It's uh we're showing
11,000 in 2025 and we're projecting 351,000 [Music] for 2026 which is over 3,000% increase. Can you explain >> that is related to the DHS mobile crisis
response grant offsetting staff cost and um that increased personnel cost of $62,000 that we we just over went over about. That's the electronic health record, too. >> Yeah. >> So, while we have an increased expenditures, we have a significant
increase in revenue, too. They're 100% reimburseable cost. >> Yeah. Yeah. Just looking at the numbers here, there's instances where we're seeing significant jumps in those revenues and understanding why that is. Uh it's it's trying to balance what we
what we see in the revenue side with what we're the uncertainty on the you know, declining revenues. And I think in when we have things that are not consistently, in other words, we can't anticipate that it's going to be a continuing revenue source that spending
those monies has to be in intentional as Commissioner Mills says relative to if we if we establish new positions and things, it has to be tied to those revenues. And when those revenues goes, those positions go because we can't
build additional financial obligation ongoing with uncertain revenues in the future. And uh you I 100% agree with that. And we recently had a meeting with um a county attorney's office and a human
resources director Grace and I um confirming that um we will be reducing the hours of one of the public health educators for year 2026 because the funding has ended and that we are in the
future when um staff is being um when positions are advertised that are tied to grants that should be clearly spelled. in those job descriptions that those are tied to outside funding and if the outside funding ends, it is likely
for that position to either end or to be asked to complete our duties within the department. Um so um with regards to the mobile crisis response grant, we under contract through year 2026. So that funding is
secured should we continue to provide those services. we have um the ability to to get reimbursed from the mobile crisis response grant from DHS. >> Yeah, I I applaud that. Huge. Huge. It's something we've talked about and and
there are many county commissioners that we speak with that that say that that discipline in making sure I mean it builds integrity into our personnel and our policy as to how we publish and present a position so a person knows
knowingly what what they're getting into and and it's a recognition of our stewardship of dollars that we have that we don't have that we can't continue to fund that on the back of uh taxpayers once those funds go. So I I really
strongly applaud that onto the child care provider wage subsidy program. Uh I'll be kind of going back back and forth between the next two slides here, but I'm going to give you a little preview here. There was a board
directive to develop program and funding support to address the local child care crisis in year 2022. $252,97 plan of use balance in 2023 for a child
care wage subsidy program. 366,645 in both 2024 and 2025. The impact is a total of 197 spots available served by licensed providers in Cook County and Grand Portage.
Um there's a impact to the workforce and and a business economic stabilizations uh stabilization as of the our um community. The 2026 budget includes no plan and use of fund balance. However, we would like to continue to support the
local child care system, families, and economic health of the community. Um, just a reminder, I'm going to go into the next slide here and show you the numbers. As there is no plan to use a fund balance,
this will have an impact on the taxpayer le. And I'm going to explain here how I um how I came up to the 253,751,000 wage subsidy program for the um for this program. So first of all, I
want to give kudos to Nancy who's worked tirelessly to launch and continue to um administer this program for our county. It's made a big impact to families and the entire community. Um so thank you Nancy.
The so these numbers that you see here are the projected um 2026 um estimated FTE for staff the hours and estimated wage enhancement amount. As you can see, um, based on the projections Nancy has
provided here, we are looking at a number of 323,331,000 of wage subsidy in year 2026. [Music] Knowing that this number will have an impact to the levy, I looked at this number. I discussed with Nancy and
administrator Kristen and we decided that we will take a different approach with this number. and I'll present the numbers to you and and ultimately this will be the commissioner's decision to what the total amount will be in the 2026's budget. But what I did is I took
the actual amount of um what we spent in year 2024 which was just completed and from the 366,000 we budgeted 224,000 was used or about 61%. So then I said, "Okay, I can take that
number and um apply it to year 2025, not 2026. I apologize. That number is $224,251." But then Nancy reminded me that there are two new providers here who are not in there in 2024. So based on estimates,
I took 61% of that expense to add it to the bottom line. And that's how I came up with 253,751. That is the number I have in the budget now which is based on 61% of the what we
spend in um 2024. And again um 61% of the two new providers which is lesser than the 323,000 that is in N's estimate. Um, so, um,
again, as a placeholder, I've I've put the $253,000 and, um, proposed no use of fund balance, which this number will um, be funded by LY because we don't have an
outside funding to offset this expense. So, one thing I want to mention is so you mentioned that two were added last year and so with this number just to be clear that would that would mean no
additional providers in 2026. >> Correct. >> That there's um great expectations program as well as heights phase 2 um as potential 2026 additions. So in addition to those two there would
not be any addition just those two that you mentioned >> our plan budget. >> Okay. >> And I was going to ask um you know that the difference between previous budgets and the actual is significant. Do you see any other potential for growth with
our current providers or does it seem like we're kind of in our in our in our track and that's that's >> you know we are always working to help our providers and I think in previous these previous three years when we've come to talk to you about childcare wage
enhancement we always um kind of look and I align it with what I put in our D grant um that this is what our goal is. So we want to say okay let's get it approved for what our pool is in case we the reality is things come and go throughout the year right the providers aren't looking at a new provider so
which is good we've always come in well under what we asked for so I think that um you know plum looking at the last couple years that average um I think that that is probably the very best way to go especially if we're trying to go to our community and ask them to help
support this out of tax dollars out of our savings account, right? So, um, so I I really applaud and love this this plan. I do think that again, >> so my thought is let's go with this lower amount and as always I'm going to
always try to seek other funding other funding how can we counter so that we are not having taxpayer dollars to do this. Um, the challenge is in this field, it's hard to be able to find funding dollars that are going to fund wages over the long run, right? I have
lots of dollars from the deed grant. Well, I think lots of dollars to help get programs started to help programs expand, but to pay your people. Yeah, that's not what we can use this for on basis. Um, but does that answer your question kind of? Yeah. So, right now we
are in the process of working with both of these, right? expectation and the heights in their second um part. So that's why I felt pretty confident that those will come online in 2026. However, if they don't open until July, then they'll be happy. We didn't need to
spend dollars because they only we only spend those when we have actual providers providing actual care or else. Yeah. >> Frank, um two two questions. One of them really brief. Um the wage enhancement comes out to about roughly about $6 an
hour. >> It does. Yes. For 2025 we're at $611 per hour that we add to childcare providers. >> Thank you. Um and Plman's the budget is based on the fact that last year only
61% of the hours that we that were estimated were actually used and subsidized and paid. Correct. >> What happens if there's a higher utilization? In other words, more spots are filled, which means more healthcare
uh child care hours, where does that come from? Does that go back now to the reserve fund? >> It's a good question. My understanding is is I see that as a not to exceed amount. But if we receive guidance from the board that if we exceed that amount
then we can dip into our fund balance that's fine. It leaves us with $134,000 still available of fund balance and I would like um to preserve those but ultimately that's not going to be my decision to make.
>> Sure. Thank you. Commissioner as to um Commissioner I my thoughts as I think about this is if we get close to that number there are ways that we originally came out kind of with a more reserved program because we weren't sure how well the funding was going to work right in
the first year. So we in that for instance we did not pay for any hours that were over 40 in a week. Um uh we did not pay for outside like administrative work that you have to do to make your program work. those hours we couldn't include. They had to only be
actual hours children care and not more than 40. Although providers work like 55 or 60 if that's their program. Um so my thought is we're going to get close if like in June I think we're going to be exceeding then we may have to put some
of those rules back in place um just to be able to stay where we need to be like um plowman shared that this is our not to exceed amount. Um so we may have to put some of those. We've been fortunate that we've been able to fund all the hours that they really are working, but
they know that um the state does not do that in their subsidy that they provide. So, we may have to scale it back. I would much rather scale it back than to say, "Yeah, too bad. We're all done. We can't do that at all." But again, those are the choices that you guys make as
commissioners and what you value for your constituents that you represent. And >> this is kind of a weird hope, but I hope that we run into that problem. because then we have more providers and more, you know, more child child care. Commissioner Gamble, you had. >> Yeah, thank you. Um, so just so it's
clear for the public to this is u to enhance wage. So we enhance at the rate of $6 per hour. >> So it's not that the employees getting $6 an hour. We just supplement the wage they're getting with the $6. The other
question I would have is, is this a discretionary expense or is this mandated? >> It's us. >> Yep. >> I believe it's discretionary. >> It's completely >> It's all us. This was based on a DHS program that started during CO and then
ended and we continued basically in that structure >> and initially it was funded with CO dollars. >> Correct. Uh yeah, I think it's always been fund balance. Um >> it's always been fund balance
except for when the state was doing it of course. >> Okay. And and this is something I'm sure we're we're aware of as well. But when we look at something and it's a discretionary decision, we say this matters to us and
important to us. Therefore, we're we're willing to take fund balance. Um but uh we we need to at that point of that commitment be looking at how are we going to fund this moving forward because fund balance won't always be there.
I included a slide from um the presentation that Nancy and did at the committee of the whole in July to um kind of reate the importance of the program and that there is still a
need for 98 more child care spots and the cost of care for providers is high for younger age groups and that the average cost of care for families is $226
per week per child. It would be um interesting to uh juxtapose that with uh the cost per household in the county. just what what does it cost every household in the county to provide um
you know this the subsidy >> versus the the cost for >> it be simply dividing the 253,000 by the number of households >> and then yeah just versus what every family is paying per week. Um, you know,
it's just interesting numbers there. Next on our discretionary funds, we have the public health fund recommendations for year 2026. The community health assessment and a health improvement plan identified goals to ensure local
resources that targeted towards the greatest needs in the community. The field health grant fund program allows us to partner with local providers to meet gaps in these community services. In for year 2026, we received
applications totaling $282,000. I have included in the budget um 150,000 in funding and um this is a decrease of 40,000 from year 2025 but returning to the amount in
2024. Again this is funds that are not offset by outside revenue and this will be these will be supported by levy. So this will have impact to the levy.
>> Um >> please Frank >> again. Sorry. Um I have some comments about this from the um from the advisory council. Um and I can mention them here
or later in the advisory council report. >> Um let's do it later. Um thank you. just uh in case I have a feeling we got a little ways to go or unless the board How does the board feel? Would you like to hear more now more detail?
>> I I would just say if it's relevant while the mind is on it. >> Okay. >> I think it'd be better to input it now. >> Okay. Thank you, Frank. Um the most important thing is you'll get our official recommendations for next year's allocations and grant recipients at your
uh next next month's meeting. Okay. Um in the interim I would like to say that although we allocated 190,000 last year this year we went on the assumption that that would be reduced by about 25%. So
again, the total grant allocations which would be recommended would total 150,000. I would also draw your attention to the Cook County Council on Aging. Um, as you can see, they requested $ 109,798.
Um, they they uh they were a grant they are a grant recipient for the for next year, but at a much reduced rate. This does not imply at all and this is something that the council wanted me to
emphasize. This does not denigrate the value of the services that is offered by the council on aging. Just the opposite that these are considered essential services and as essential services
should not be dependent on these discretionary funds but should rather be a line item and I don't know the financing and budgeting details of how that's done and what the relationship
would be but this should be a decision that the board makes to support the council on aging's provision of essential services to the county population. >> That's what I wanted to emphasize there
>> in your budget deliberations. And as Commissioner Gamble said, yes, you have to balance what we'd like to do versus how is it going to be paid for. >> And that's the commission's decent job. So, thank you. >> Thank you. Thank you for your work on
that, too. Okay. And again, this is the 2026 public health and human services preliminary budget. Um, I'm sure we'll be making changes to it in the coming days, but that's the information we have available as of now.
Um again no use of fund balance um as uh proposed and uh just for perspective um as as presented it's roughly very roughly uh
about 7% levy increase overall um big levy not BHS >> 3.75 5% for PHS if you take the fund balance into consideration. >> I'm sorry. Can you say that again?
>> So the net the net county cost is increasing by two 3.75%. >> But because we don't have any use of fund balance it skews the numbers and it looks like we're asking for a big increase of the LE which >> Oh yeah. No, not on you. Yeah, it's purely because of the not use of fund
balance. Commissioner G. >> Yeah. Thank you. Yeah, it's um it's a huge undertaking public health human services huge. The other thing that
is influences this is because it is such an emotional thing related to the well-being of the people in our community. So when you take the emotion and you take the complication and you take the other part of it which is the
mandates and things like that it it gets unwieldly which speaks to staff that invest themselves in trying to look at the detail to be as good stewards as you can which is hugely important. It's
important because we need to balance what we do what we have to be able to fund this and building the trust relation with the public in an area that is so emotional. Um but when I look at it and I say in this year if if we came
in and we said we just we need to stay at where we're at or we need to reduce it because we see a reduction that's coming from all of our funding sources whether it's on the federal level where it's whether it's payment in lie of taxes whatever it might be those are
realities that we have to deal with and that's what is challenging but it's an opportunity for us to build that trust and demonstrate our fiscal responsib ability. So when we look at this in the context of 3.75, if we said it needs to
be flat, no 3.75% increase, then u we do what we have to do. And I I go back to Milwaukee County again. If 80% of the everything's mandated, what do we do? If those costs are going up and we're not getting revenue, we're
stuck. It's a real challenge. But the point is is that because we aren't using fund balance or the family isn't taking from their savings this year, then we're stuck with a 27.8% increase. And in this year, looking at
the budgeting process, 27.8% increase is is not is not acceptable. when you when you say that I say it in the context of the empathy for all of the things that I previously
mentioned, but the point is is that boy, that that's tough. And we can say, well, it's because we we can't take from our our savings. And we've used that to try to mitigate the impact on the taxpayer, but we don't have that opportunity. And that's a reality that we we constantly
discuss when it comes to fund balance. But, uh, I would just encourage looking at this. The 3.75 doesn't look look so bad, but it'd be it'd be best if we could try to bring that down in view of the fact that we're we're not going to
be using fund balance, which then brings it to the 27.8% increase, which is in this environment pretty. >> Mr. Commissioner Starley >> Plumman, could you go back to the
previous slide PowerPoint before that? Another one there. Could we could I get a copy or all of us get a copy because this is a lot to consider especially in the light of the fact that there's been discussed
that perhaps we would um do the um council on aging. So, I think um I would appreciate just this um so we can put it into our mix of everything to remember what all this was already considered. I'd appreciate it. >> Right. And again, this does not include
recommendations for 26, >> right? >> You'll be getting that next month. >> Those slides will be attached to the minutes. >> Great. >> It'll be attached to the minutes. Yeah. >> And if you would like a copy before we leave today, I can have Janna make
copies. I would like a copy before the minutes because that's a month away. Okay. Thank you. >> Thanks, Pman. >> Question. >> I also would like a copy before the minutes. >> Okay. Thank you.
[Music] Uh thank you Plowman for that that report. Um, as Commissioner Gamble said, not an easy um, task here. Um, this moves us on to a director's
report, staff updates. We have our org chart. And again, I'll pass it over to to Fman. Most of the updates I have are on from the public health team. um
August and September events that involve the public health team support at the fisherman's picnic table including providing a lactation tent for families. Christina Matson will be presenting at the August 20th meeting of the Aroath
Birth Collective at Cook County Higher Ed on Lactation at 6 PM. The public health team will have a presence on the afternoon of Friday, September 9th at an educational tent which will feature information about 988 phone line
prevention, harm reduction, and other public health topics. The mobile crisis response service is active with Andrea RS continuing to serve in our class appointment both to respond and to support program administration. I want to make sure I acknowledge Andrea for all the work
she's been doing. Thank you. The public health vending machine has arrived and has been placed in storage for now with plans to conduct additional community engagement this winter prior to installing the machine in the community.
Speaking of cannabis, re regional communications campaign is active this week with both digital and print-based ads to be placed across the 4ount arrowhead region. This campaign is targeted at parents, caregivers, and others and other adults to empower them
to educate themselves regarding the health impacts of cannabis and to have honest conversation with the young people in their lives about cannabis. The Food Access Council has its first seven voting members. An action group
continues to work with the local food shelf to explore the super shelf model as well as ways to support more generally. The council is also starting a multi-part conversation about food insecurity among you among youth, hosting a series
of guest speakers who work with youth and families around food access. Christina Matson and her work with the safe routes to school is supporting GES to provide parentation materials regarding a drop off and pickup areas
and they prepare for this as they prepare for the school year to begin. Andrea Tuft is preparing for a September National Preparedness Month initiative to engage local businesses in educating the community on how to prepare gobacks.
currently reaching out to business partners to gauge interest. Grace Granager has continued to work with care partners, Nchure Health and Nurture Healthc Care Foundation and the South Mountain Clinic to develop the
vision for resource directory website. They have reviewed contractors following an RFP process request for proposal and initiated communications with the vendor who the group agreed most closely
aligned with the needs and vision of the project. The goal is to bring a contract for this grant funded project before a board at future meetings hopefully in September. Grace is preparing a September presentation um as I mentioned earlier
for both our PHS and local mental health advisory councils on how federal budget changes may impact local PHS service provisions. This is a topic that she would be happy to present to the PHS board at a future
date as well. Thank you. I um I failed to um consider our additional item here um item E um from our consent agenda and that was supposed to be addressed first. So my apologies there, but could we could we go back to that? And um Commissioner
White, you wanted to go into a little more detail there. Well, I would just like um for the public's sake to have um have it explained in a very concise way what we're doing as a county and why
with the uh um this is to approve a service agreement with the University of Wisconsin Superior for mobile crisis response needs assessment. and perhaps Clman can best uh iterate
um the goals of this and how it will be helpful for our community. >> Actually, I'm going to ask Andrea to provide an update because Andrea has been working on the mobile crisis response administer and to respond >> and I would suggest that maybe having a
microphone brought over for Andrea would be helpful >> just so the public can hear clearly. Makes sense. >> Good morning. Thank you. >> So the uh let me swap
the needs assessment is uh written into the deliverables of the startup grant that we have for mobile crisis response. And I was not part of the beginning conversations, but what I have determined is that
um the needs assessment would outline potential other mobile crisis response options that we might have as we move forward with the process. Keeping in mind, similar to the conversation that
you had earlier about um the cost of providing a service versus the service need because our call volume in Cook County is so low and it is a statutoily required service that has to be provided. The needs assessment will help
us in collaboration with Northshore Health, Sawtooth Mountain Clinic, Grand Portage Human Services, HDC, and the Arrowhead Behavioral Health Alliance to determine what other potential mobile crisis response models exist that we
might be able to utilize in the future with the potential that, you know, grant funding might not always be be available to offset the cost. If I may add, um that cost for this
contract is fully covered by the mobile crisis grant. So there will be zero impact to the levy. Um but just wanted to make sure that's clear. >> Thank you, Minister. And if I can add as well, um I was very pleased to see this
proposal and um this project um overview um provided for the crisis response team because this really allows us to have the data to be able to determine the best path forward. Um and so um I just wanted to mention that I this proposal
was very well done. The cost is incredibly reasonable. Um in my past role prior to coming um here um I was a consultant supervising um a team that did work like this and this is very um very well done.
>> All right. Any other uh >> No. >> Okay. >> Thank you. >> And and so yes, Commissioner Sel. So, I'd like to make a motion to request that we approve the service agreement for W Superior's Center for Research and Evaluation Services to provide mobile
crisis response needs assessment. >> Thank you, Commissioner. >> Thank you, Commissioner White. Any further discussion? Hearing or seeing none, all in favor? >> I opposed. Motion passes unanimously. Thank you.
Okay. And um anything else under your director's report? Okay. Thank you. >> That moves us down to items for board action which is very quick today. Nothing there. And that moves us down to our committee reports. And u we'll start with the active living steering
committee. Commissioner White. uh many many items, but the one um to really to know about is that this coming starting now in this coming year, they're going to do a very comprehensive um
assessment and then brainstorming on how to move pedestrian and bicycle non-motorized travel safely from GES around the Gunflint past the apartments and then down the street trying to
minimize fatalities. >> Good. >> There's that trail going on, right? New spoken. >> Yes, that's that's it. But they wanted to make certain that they get it all right to start with. >> It's also good.
Thank you. Um, next one is the Arrowhead Economic Opportunity Agency. Commissioner White, >> it meets tomorrow. And I imagine they're having some challenging discussions as well. >> Yeah.
>> Um, Arrowhead Health Alliance, any any updates there? >> No, they did not meet this month. >> And then ARC, Arrowhead Regional Corrections, Commissioner Gam. >> Yeah. Thank you, Mr. Chair. Um this is minutes from our uh July 18th meeting
and then we did have a subsequent meeting that Commissioner White and I attended as well. Um they reviewed the pre preliminary budget. It's a challenging year for budgeting which we are all familiar with. One of the big drivers affecting
the budget is health insurance and it's projected to be 10%. It could be as much as 20%. In this last meeting, they settled on the 10%, but they did say it could it could jump. Um, Cook County's contribution to ERC for 2026 according
to the preliminary budget is 211,583 dollars. So, uh, we have Cook County, Carlton County, St. Louis County, Cooching County, and we are in Lake County, and we're all in this uh joint group through the Arrowhead Regional
Corrections Board. And um when we look at our contributions as counties to support NERK, uh this 211,583 that is projected for 2026 budget is 51%
um a reduction of 51% over our 2025. So it's about a half of what we've been paying. And if you want to look at that, that's uh 131,000 from our 2023 contribution. In other words, it's
reduced 131,000. And if you look from 2017 through 2023, a period of 7 years, our contribution averaged over 300,000. So we're we're down about a 100,000. Uh
it is based um on our participation. That means if we're sending individuals, if you look at the statistics uh relative to admissions to Nerk since 20 2008 during this period, the highest occupancy that Cook County had was in
2010 where we had 10 individuals. Since 2016, the number of individuals admitted has been six or under. In 2024, as Commissioner White had referred to in a previous meeting, we reported no
individuals admitted from Cook County. Commissioner White and I had a discussion about that with the director in this last meeting and uh trying to understand that. Um and that's something I think that needs to be looked at if we
have this partnership. Um are we using it uh to the extent that we should be using? And I I'll comment more on that. Here's some of the um comments that come from individuals who have participated in NERK. Um the individuals writing
after being in the program, they say a better person and staying sober. I got my sobriety. I got good advice and I felt like I gained knowledge about my decision-making. I remembered who I am. I learned how to identify my emotions. I got a parenting
certificate, learned about housing and other stuff. I also got my GEDD. Uh, time to reflect, got my life back. To reinforce that, according to a December 2024 Minnesota regional county jails consolidation or merger study
conducted by the Minnesota Department of Corrections um as commissioned by the 2023 Minnesota legislature, the Northeast Regional Correction Center, NERK, was recognized as a model facility rather than functioning as the
primary detention facility for Carlton, Cook, St. Lewis, Cooching, and Lake counties, each of which maintains its own jail. NERK provides specialized programmed based options. This hybrid approach allows participating counties
to maintain local control while assessing shared resources for specific inmate populations, particularly those who might benefit from specialized programming. This model illustrates the potential flexibility of regional cooperation demonstrating that
collaboration need not require complete consolidation of all correctional operations. So basically when you take the comets and you take this recognition that is come by this consolidation merger study uh we have a a very very
good facility that models programming that is very human and relational and you can see by the outcome of the participants that it is it is a good program. um during my first term as
commissioner and attending the uh MAC conference which is the correctional in the state that we've often looked at our programming approach and um Minnesota has a a a good program and NERK has a superior program when it comes to how we
deal with offense and trying to restore individuals and um the next meeting for uh NERK in September which will be at the 19th. We will be meeting at the new city conference and um like to invite
you to attend. So you can meet the folks there. They're eager to meet you and certainly anybody that would like to attend that September 19th meeting. Uh they meet at uh 10:00. But uh we can I'll have Jenna send out a notice to as a reminder.
Thank you. >> And I want to re reiterate as last time the the the obvious care and teamwork of this all the individuals at NERK is astounding and I believe that is why
they are so successful. Anybody there can do just about anything that anybody that is staying there needs. It's not just lockup. It is educational. it is counseling,
social um help and uh I it's an astounding thing to be able and they actually said it out loud that they were a team. They worked at a team at this last meeting but I could sense that from the other meetings that this is a
welloiled group that that cares and that is what people in trouble need. So, >> it's evident it's not just a job. >> Oh, definitely. >> Yeah. >> Wonderful. Thank you.
>> Um the next um committee report would be the child care solutions subcommittee. Commission, >> we have not met, but I think we all remember the great presentation that Nancy gave us at the committee of the whole. Yeah. >> So, I'll let that stand as a report. >> Yeah. Thank you. uh community health
board. We did meet um again difficult uh discussions there. There was another grant received uh in an effort to um go after food security as well. Um
um I cannot recall what the doctor uh reported on but Frank do you want to add add comments? >> Yeah. Well, the food grant was the climate smart food systems grant >> and it's not food grant per se. It's like the intersection between climate
change and and food security and sustainability. Um and we yes we are participating in that along with the other the other four. Dr. Kufall talked about the health hazards to do with smoke inhilation >> wild from wildfires etc.
um and pointed out that um not to throw too many numbers a tiny increase in the particulate matter in the air can lead to a one to two and a half% increase in overall mortality. Um in other words number of deaths even
from relatively small amount particularly the very young very old and those with respiratory problems. So, um, if it's bad out, don't do the things that are going to increase your respiratory rates. Not the best time to go jogging. If you do be have to be outside to work
or something, break out those old N95 or KN95 masks. That's what they're for. They're they're particulate masks for things like smoke. >> Thank you. Um, next one is the uh mental health
advisory council. Um, rant, >> we did not meet. >> Okay. And next committee report would be the Cook County Restorative Justice. Commissioner G >> summer hiatus. >> Very good. And next one is the Council
on Aging. Commissioner White, any update there? >> No. humming along and and seeking money and >> and as I reported last time they had a thousand people sign in to their space using and it wasn't just to eat it was
using the different services that are offered through there so >> significant thank you uh emergency preparedness committee um commissioner Sullivan >> thank you um so we had a meeting recently and had an
excellent turnout. Um, new or relatively new participants. WTIP was there, the Red Cross was there, Grant Portage participated, uh, many of our partners and, um, we had a new representation from the West and Kathy Johnson. So,
we're really happy to have her join us as well. And we went through cyber security discussions which were quite timely and talked about uh various questions like does the various organizations
participating have response plans or do they have policies around it. So the school district, the hospital talked a little bit about some of their cyber security incidents, how they responded and um we talked about communication within organizations during those events
and also between partners and shared gaps and vulnerabilities. But it was again very timely and um was really excited to see that we looked at this. We always talk about weather events and fire and this is, you know, something that in this day and age is just
happening everywhere to everyone. So, I really appreciated the discussion. >> Thank you. Next um committee report would be the healthcare planning committee. Commissioner Stoley, >> um we have not met.
>> Okay. Then there's Niko. >> Then there's Niko. We'll have a discussion the first week of September. just reviewing all of the different items that was brought before the Niko conference in um Philadelphia and um try to sort out some of the
important things to maybe dwell on and discuss over the next few months. >> Thank you. Uh Northeast Minnesota Office of Job Training, Commissioner Gamble. >> Yeah, another slimmer. >> Okay, >> we will be meeting in September though.
Okay, >> I've got confirmation that September will happen because I figure the summer will be gone. So, >> yeah, things will calm down. Uh, Northshore Collaborative, we have not yet met. Um, just got a request for updates. Uh, so we'll be meeting I'll
have a report for for next meeting. Um, and then the uh PHS advisory council, Frank, anything additional you wanted to add there? >> Uh, no, just that the uh council as a whole did not meet. Um the only activity was with regard to the um public health >> fun
then Cook County Food Access Council Bowman reported on I actually missed that meeting again um but uh several member council is formed established and that would kind of a lot a large part of the previous um meetings relatedly uh though I was able to attend the um
Northwoods food project which is focused more towards growers farmers um and one kind of fun thing there is the um library of equipment for food processing. Um so if you want to spread that word out um it's quite a resource.
Um if uh one person tries to uh own all of the equipment, it's you use it every now and then or whatever. So having a shared resource makes a lot of sense to be able to do canning or dehydrating or however however you want to prepare
food. So pretty excited about that. also uh finally got a chance to meet their uh director and um that's very exciting. a lot a lot of uh energy there and and focus and drive and so um it's a new
chapter I'd say for that group and that's a grant-f funed position so looking for funds and understanding that that was actually part of the job was to also look for yeah um but uh but yeah that's that's that's it's been great
thus far um anything else for the good of the order from Please, Frank. >> Yeah. Commissioner, back to the food access council. Yes. U has word gone out about how you can make how you can donate >> equipment, >> the Northwoods Food Project?
>> Mhm. Yeah. The the library, the equipment library you mentioned. How do you >> donate to it? >> Yeah. >> No, I don't think uh I So, they they h they have the equipment and now it's ready to be uh >> I don't know if they're looking for more equipment.
>> I believe they are. that that was a discussion that came up during the grant stuff. >> Um, that's okay. We'll I'll contact them directly about how how to donate equipment to it. >> Okay. Thank you. Yeah, Commissioner Gamble. I >> I wonder how that uh parallels with the
University of Minnesota Extension because the equipment that >> they're talking about that program >> there use of the kitchen. >> Yeah. Um Sarah Waddle is on the Northwoods Food Project board. So, >> yeah. So I I think they must be the same program that that we're talking about because basically it's it's a
>> it's there. Yeah. It's at the community center. >> Yeah. >> Yeah. Yeah. Okay. Because we we're talking about >> I'll talk to Sarah about it. >> And and if your comment was about are they taking donations if you have something you want to give them? >> Um I I assume that they would if if it's
something that's in condition and something that they need. >> Yeah. Okay. >> But I think it's it's it's great the the program so that people have that without having to invest. >> Absolutely. >> And then it gives them a chance to find out if they want to move forward. And
>> so >> and they'll be they'll be doing uh demonstrations as well. Um I think there's um going to be kind of a potluck and then a cider pressing and um and then at the far farmers markets as well which um is quite quite the event. Um, I
think there's hope to to kind of give some little demos there or at least show what can be done. Maybe not do it right there and then, but um, yeah. Um, there was something else related to that, commissioner, but oh well. Okay. Uh,
anything else for the good of the order? >> I just have one. >> Thank you. Um, one thing to add, I know Plowman had walked through our organizational chart for PHS. we do have a number of vacancies and so we are looking at filling some of those at the
same time also looking at the organizational structure for the department and operational efficiencies as we move forward. >> Thank you Commissioner G. >> Yeah, thank you. I I just would make a comment to that that anytime that that
there is change, it gives us an opportunity to step back and and evaluate and and certainly um uh this is something in making comments which I did today relative to departmentally excess
assessing what is mandated and um what we choose from a discretionary standpoint to include in the services that we provide. looking that in the context of the revenue that we have but I would I would just encourage relative to public health
human service that that evaluation we have that opportunity let's do that and evaluate it in that context of what what is mandated and what we need to do. Thank you. >> Thank you.
>> All right hearing no other um comments for the good of the order it brings us to adjournment and we are adjourned. Thank you. I have my list. >> It's going to take some time, but I all of your questions were good questions.
I guess some time