say that or or say that the um state of Minnesota runs on on the state fiscal year. So um it ends in uh is it July 1st, end of June, beginning of July. So these are statistics from last year. We had 91 open cases and 106 kiddos on that
that case load. Um our collections on a rears measure is up from 67 12% to 70 12%. And that is anytime we collect $1 of a rears in any given month for any past case that counts towards that. So it's not a dollar for dollar. It's not
like we were owed $10,000 and we collected $7,000. It was just on any one of those cases if we collected anything uh that counts towards that measure. Uh secondly, our patern paternities established measure increased to 116.13%. Now this is confusing. How can it be
over 100%. Right? So it takes the previous year's kiddos that we have on our case load and any of them that were not married at birth. So if a child is married to a mom and a dad or child is born to a married mom and a dad, uh that child is automatically legally their
child. Child support didn't have to do any work on that. So we don't get credit for that. any ones that we do get them to sign a recognition of parentage or we bring them into a court and we adjudicate parentage, we get credit for those. So, it's this last year's number over the previous year's number and
that's why our numerator was bigger than our denominator and we have 116%. We are the second highest uh in the entire state on that measure out of 87 counties. So, we're really proud of that one. Um, as proud as I am of that, um I do want to temper it in saying a lot of
that is outside of our control. we can't we can't make kids be married or or be born to non-married parents or vice versa. So, a lot of it's outside of our control, but it does show that we are establishing paternity on all the cases that we can. Um, our orders established and that is just making sure that we
have a support order on our cases is at 86.53%. We are above the state average there and our collections on current support uh decreased from 80.84% uh decreased to 80.84%. 84%. Now, I was in a meeting with with Kristen and I
think we were the fourth highest collecting uh county last year and you said, "What would it take to get to first?" Unfortunately, we dropped to seventh, but I still feel really good that we are in the top 10 of the we're in the top seven of the entire 87 counties on that measure. Um, and so what that is is when support is due in a
month, we are collecting it in that month. And that is a dollar for dollar. So, we collect 80% of all money that is due in any given month in the month in in that given month. Um we dispersed $218,000 in 2025 um for kiddos on the uh Cook
County um child support case load. So those are stats and figures. Those were fun. Um I mentioned this last year. So here's just some what's going on in the world of child support. Uh we finally implemented I pay online. So it used to be where there was only a few ways you could pay your child support. You could
walk into an office and write a check. You can mail your check into the child support payment center or you can come in with cash and accounting would figure out how to receipt a check a check down to the state. Um or your payments would come directly from your employer. That's the most common way. But now we can take e checkeks, debit or credit cards and
e-wallets such as PayPal, Apple Pay, Google Pay, and Venmo, etc. Uh I feel like that was an advertisement for them right there. Um we're unsure how good that is is going to work. um there's no way to measure it on a month-by-month basis. So, at this time next year, I'll
be able to tell you, you know, we dispersed $218,000 and of which, you know, $20,000 came from e checkeks or debit cards. Um so, right now, we don't know how that's going to work, but I can't imagine it. It can't hurt, right? I think we're in the world now where that's how most people pay their bills. I have one bill I still have to write a
check for every month, but everything else is either automated or I, you know, jump in and put my debit or credit card information in there. So now we can take child support payments that way. Uh Minnesota is only one of four states who still automatically run a cost of living increase for our obligor. Uh Ramsey
County um they have a bunch of um uh people who work directly on on legislative matters. Um they are looking at repealing that statute language in the next legislative session. It was actually on the docket for this one, but it was pulled. I don't don't get I don't understand all the legalities of why it was pulled, but it was pulled. But it's
going to be on the docket for next session. Um, and so right now, every 3 years, your child support automatically goes up based on cost of living. And again, we're one of only four states that still do that because that's not the reality of a lot of people's, you know, actual
jobs. They didn't really get the 4% raises every year for the last 3 years. Um, we know cost of living is is high right now. Um, that doesn't mean that that obligores necessarily should automatically have to pay more. What it does do though is they're leaving the statutory language that we have to
review those cases. And so we'll take a case by case basis on all of those cases every 3 years to see if they should go up. And if they should go up, we'll start a modification. We'll bring it into court and we'll we'll get those modified. Um the Americans with Disabilities Act provisions have directly impacted a lot
of child support court filings. Um so we now must ensure that our our uh court orders are fully accessible by April 24th of 2027. They gave us another year because we were not going to to make it in time. Um, our our statewide child
support system doesn't easily allow this. We haven't antiquated. I've mentioned this before, too. It's a DOSbased system from the 1990s. I think it was built in 1996. Um, it's written in what's called natural coding. And down at the state, they had said there's about a dozen people who even know how to code that anymore. And those people
aren't going to be around forever. So, we have to have a new system. I think it was 23 to$28 million. I I always forget the number. a few years ago was actually earmarked for us to upgrade for the state to upgrade the Prism system. And because of the way government works, it's taken its time and we've been
trying to figure out what what that's going to look like, what the system's going to look like. Um, the look and the feel of this DOSsbased system, if you've ever been in DOSS, when you get good at it, you you can move really quickly through it. Tabing and typing and tabbing and entering and putting a P here and tabbing and entering, you can
you can move really quickly without ever needing to use a mouse to go up here and click. But our workforce, the newer workforce is not used to those type of systems. They're used to Microsoftbased systems, SharePoint, SharePoint systems where you can go in and you can double click something, enter your information, you know, go over here, double click
something else, enter your information. So again, we're not exactly sure what it's going to look like, what the what the look and the feel of it is going to be. Um, but again, we've got tens of millions of dollars, so something is going to be changing soon. But back to the Americans with Disabilities Act, because I went off on a tangent there.
Um the state has created Microsoft Word templates for our for our court orders. Um that that makes it much more labor intensive. Uh no court order is exactly the same. You might need to put a paragraph in explaining, you know, a non-custodial parents um situation, a
custodial parent situation, living arrangement situations. there there there are hundreds of paragraphs that these templates are automatically built with and staff have to go through and pull out the hundred that they don't need and add the you know 10 extra ones that they do need. Um right now it's
creating about an hour more of work on every court order that we do. So it is very labor intensive. Um and those are only a few of the examples of the why um child support is becoming more difficult. Um there are fewer and fewer cases where married
where parents were married had a kiddo got divorced and then we get a child support case where we have to enforce it, you know, and it's just easy easy as that. Um there's more cases where we have to locate parents. We have a more transient clientele. We now have
multi-state cases with in Cook County with Michigan, Iowa, Wisconsin, Ohio, Washington, Missouri, Arizona, Maine, and Indiana. So, those are the other states that we're currently working with on our case loads. And so, that takes a lot of work, too. Um, not every state has a worker where you call it, you call
a number and you get a worker. Um, some states are run differently where you call a call center that's just based in, you know, the capital city or the biggest city and and you wait on hold and you get somebody who you hope knows, you know, enough to tell you what's going on with that case. Um, so staff sometimes spend, you know, 45 minutes to
an hour on hold waiting for, you know, to get a hold of somebody. Um, I was going to throw Texas under the bus here right now. And I am going to throw Texas under the bus, but we don't have any Texas cases in Cook County. So, we're okay for Cook County and Carlton. We have Texas cases and Texas runs that way. It's really hard to get a hold of
somebody in Texas. And then sometimes you have to leave a message and just hope they get back to you within a couple of days. Um, uh, along with the Americans with Disabilities Act work that I had already mentioned, we've been tasked with e-iling our own paperwork. Now, this happened a handful of years ago, but I'm just adding it to this list. Um, court
administration used to do that. We would, you know, email over or walk over paperwork to court administration and they would take care of all the rest of it. Now, we have to efile everything on our own. Um, we have to do intensive safety searches on all of our cases. Super important. We want to make sure that there's no um, you know,
restraining orders or harassment orders or anything out there before we start mailing out paperwork with addresses on there. Um, but again, that is intensive. We have to look through the MGA system, the the to look for all of those types of orders. Um, before we suspend a driver's license,
now that statute changed. There's 11 different reasons to not suspend a driver's license. So, it used to automatically happen. Um, if somebody met criteria, that information was sent over to DPS. DPS would do what they needed to do. They'd send us, you know, the information back that, hey, this license is suspended, and then it would be done. Now, there's a whole bunch of
review that has to go into it again for these 11 different reasons that we may or may not suspend that driver's license. Um, and I've also taken on a few different roles over the last handful of years. I'm on the child support advisory council. I represent the 13count region uh up here. Uh, put putting me at the
forefront of some important decision-making at a statewide level. Um, and because we have a twocount partnership, I was also asked to be on the pilot project for increasing our collections on current support. I partially think it's because Cook County was the fourth highest collecting county and then secondly because we I work in
two different counties and so they thought you know there could be something to be gleaned from the type of work we're doing you know as a region. >> Um I think we have at least a few ideas that are going to help us out with that collections on current metric but just like the online payments I'm not 100% sure you know I can I can I can flip a
lever right now but I won't know if that actually did anything until I can check the data about a year from now to see if that actually increased our collections at all. And that is all I have for you today. See, I talk fast. >> Way. Thank you. Um, always a pleasure to
have you here. I bet you we have some questions. Commissioner Gamble. >> Thank you, Mr. Chair. And thank you, Dan. Appreciate it. Um, analytics uh are beneficial to the extent that they inform how we conduct
business moving forward. So when you look at it, you're able to evaluate effectiveness and uh stewardship responsibility. Um you referenced early that uh I think we were in the fourth or seventh position
and it may be connecting this to the to something that uh that's that's the wrong figure, but you said that's not from anything that we've done. Do you recall in that comment that you
said we're in this category and was that the one you said what would it take to get to first that so those are two different we're at 116% of our paternity establishment and that's the one where I wanted to to temper that a little bit because again we can't control if children are born to
married parents or not elections on current one I feel very confident that it is because of the work that we're doing that if somebody calls us we pick up our phone you know immediately or call people back almost immediately. I didn't mean to jump over you so I apologize. >> Yeah. >> Two different and what that uh for me in
in hearing that is that while the figure if we say it's nothing we can do that analyzing and understanding from the context of saying what is it about this region or this area that makes that conducive and it be let's just say that if you look at farming there are areas
that are conducive to raising this at at a lot more bushels than you're going to get over here. just because of the culture, the environment of the area that you find yourself in. So, it doesn't mean that numbers can't tell you something. It just again, you know, what do you do? But the other uh comment was
the fourth highest collecting in the county. Is that is that related to um our process of getting things done on the timely basis or is that related to a dollar figure? >> So, that's a dollar figure. So, we we went from fourth to 7th. That's the one
where I told Kristen I wanted to move us up to first, but I couldn't get us there. We actually dropped a little bit. So that's dollar for dollar. So when we when we dispersed $218,000, I can't do the math really quickly, but that was only 80% of of of what we could have dispersed, right? So whatever that is,
add 20% to that and that's what it is. 8 200,000 of 250,000 or whatever is what we >> and and uh if you're just listening and you don't have a context, understand this. When you say a fourth highest uh collecting in the in the county out of the 87 counties, you could interpret
that to mean that it's the amount of revenue we're getting. But it isn't. It's it's of the available or those that potentially we can collect that we are doing a good job of getting that. And that's what puts us in the fourth position is because we're getting uh a
large percent of what we can get because of our timely filing on those things. Correct. Yeah. It's not a revenue. It's it's our dispersements to right >> parents to then the families and kiddos. >> Yeah. And so like I say, analytics beneficial when you understand it in context and you know what you can do to
try to try to change that. >> But to staff and people that are responsible in this particular area, that's very affirming um when you see that kind of productivity and commitment to what what you're doing. How many years have you
been in the position? uh right right about when 2015 so right about when we took over the Cook County contract we had it for one year and then I took over as the super >> and what is the most significant change you would say that affects that department over that period of time
>> that's a really good question I think I'd have to think >> only one right um boy I don't know that a good question I I think you see it changes I think it's keeping up with the the the legal changes that change every year. So we
the state has used this terminology. We have become kinder and gentler. So the child support of when I started was if there were birthing expenses automatically the non-custodial parent was going to have those added to their aars balance immediately. Right? So that could be 4 to $10,000 immediately. And
so that put non-custodial parents kind of behind immediately. Um instead of saying wait a minute I didn't even know potentially I didn't even know this child was mine. I didn't know how much this was going to cost. I could have planned for this. whatever it may be. Um, that went away 10 plus years ago. Um, the driver's license suspension,
again, a lot of these things that used to just automatically happen, um, no longer happen. Um, we have what's called good cause, uh, good cause to not have a child support case. So, when you get on medical or cash assistance and you have
a child and the other parent is not in the household with you, a referral automatically happens to child support because the state says, "Let's find who that other parent is, that non-custodial parent, and let's let's have them potentially pay a little bit of something towards this cash or medical assistance that we're given for this kiddo." Um, but there are reasons why
that shouldn't happen. Maybe you fear, you know, for your safety to have that other person involved. So, good cause. I think that last time I came here actually I talked about this um good cause has become more broad now where you don't need you don't need to prove to me that you're afraid. What would you
give me that would prove to me that you're afraid? You telling me you're afraid should be enough. I should believe you and not have to have you have a restraining order against somebody or court, you know, police report on somebody. And so we've gotten and so kinder and gentler um helps out
in many ways I think for participants. uh makes our job just a little bit more difficult in like figuring out what to do on cases and to analyze cases a little bit more. So I think but again that's not one thing that's many things. Sorry, Commissioner Mills. Um but I think that es and flows with many different things.
>> I was joking. >> I'm glad. >> And when I hear kinder and gentler um I think that's a good description. I also think it's smarter because we know a lot more uh about people and society and how things work or what does or does not
work and uh it's a very very complex system and many complex situations and so um I feel like what we have learned through evidence is to take that approach and that brings better results. So, um, >> yeah, >> but that's just my editorial.
>> No, I agree. Um, going back to the if you added $10,000 in a rears to somebody's case who's a 22year-old kid with a part-time job or something, right? He he he or she, sorry, the Nodia parent immediately is, you know, just again behind the eightball and trying to
get all that caught up and get their life figured out and they're a young, right? Exactly. Good luck in trying to do that. And so the evidence, the data, the analytics had shown that those weren't getting paid or those people were then not taking jobs, taking cash jobs, getting paid under the table, not making those payments. We were writing
off these payments sometimes down, >> right? Yeah. Collections collections were low. These payments usually weren't owed to the custodial parent who paid for it. They were owed to medical assistants who had paid for the birth of that child most often. Um, and so then we would just write those off. We have we have a write-off policy. So, you
know, six years go by or whatever the the the cut off is and no payments come in on that, we write it off anyway. So, then it's a bunch of work, >> nothing, >> right? And then we all pay if it's time. >> Yeah. >> Right. >> Uh administrator trouble. >> Thank you. So, first of all, Dan, I want to say thank you for your work and I'm
glad we're still in the top 10. >> Yeah. >> So, we're still doing great. So, but it is incredible um the the work that you have done with this this group. So, thank you for that. I do have a question about you mentioned the modifications every 3 years. Yeah. Does that have a
staffing impact? >> Meaning um so if that was automatic through the colas every year and now your staff have to review those every 3 years, are you anticipating that that is going to mean you may have to hire additional staff or what does that do to
your current workload? >> I don't think so. I I could see that happening in much much bigger counties than Carlton is for sure. Cook. it's not going to be a staffing impact um for the 1.0 that that is in our contract right now. I don't anticipate that would be a staffing impact um for us as well. I it's I don't know all the ins and outs
of it yet because it hasn't happened yet. We haven't actually repealed the COLA statute yet. So the automatic, you know, every 3 years yet. Um I imagine there's going to be some training from the state on what needs to be reviewed on those cases. Um you know, what's what did employment look like? What does it look like now, right? How much did they
make? How much do they make now? um Minnesota takes both parents income and it goes into a calculator. Um it's not um it's not terribly difficult there. Again, there is some some analyzing that has to be done on, you know, maybe they work part-time, but they could work full-time and have to impute a little
bit of income. You know, there is some figuring that needs to be done. Um but no, I sorry to make a question longer or an answer longer than it needed to be, but I don't think it'll affect staffing. >> Okay. Thank you. >> You bet. >> Um uh Frank, yeah, I saw your hand and then Commissioner Gam after that. And we
can't see Frank right now. Oh, okay. You're on it. >> That's fine. Go ahead, Frank. We can hear. >> Okay. Um trying to get my video back on, too. Okay. Um question for you. Um I understand the collections for last year
were about 218,000 and and that's great. Uh tell me, who pays for this? Is this a something that's added on from the uh uh from the uh from the person paying child support? Is the county reimbured? Does Cook County reimburse Carson for this?
And how much does that how much did it cost us to collect 218,000? >> So, who who's paying for the 218? Is that the first question? >> Who is paying for the cost of collecting >> uh child support?
I don't know how that works. I'm sorry. >> Yep. We have a contract with Cook County. It's $139,000, I believe, per per year right now. We haven't negotiated for next year yet. Again, cost of living is increasing. Our um you know, staff is are going to get
uh wage increases, I hope, and uh cost of health care increases, you know, continue to happen. I mean, I wish those didn't happen. Um and then those are 66% reimbured from the feds. So, child support is a federal program that is 66% reimbured. So, I'm not your accountant
on this level, but I'm guessing all the costs included in that contract get uh submitted to the state for 66% reimbursement. Sorry, I think Grace, you might have been saying >> that sounds correct to me. >> Okay. >> Did you catch all that, Frank? >> Yeah. So, basically, Cook County is paying 45,000 to collect 218,000 for our
citizens. That's not a bad deal. >> I'll take I'll take a four for one. >> Thank you. Any any other questions right now? I'll pass it to Commissioner Gamble. >> Yeah. Thank you, Mr. Chair. Thank you.
Really appreciate your work and um um you exude confidence that comes through your experience even though you're feeling a little under the weather. It must be what you're drinking. But um I uh my question is given the leadership
positions that you find yourself in representing you know collective groups and things like that what's your experience given what you learned through your lived experience in trying to get leadership that enables change to
take place. Do you feel that you're being heard or do you feel that very frustrated because of the opportunities we have to improve but those that can help us do that aren't listening? >> That's another really good question. Um
I think it's somewhere in between. I feel heard but I still feel like there are things that can't be done. I mean there are budgetary constraints obviously at the statewide level. um I could have all the best ideas in the world to build a new computer system that will work and do everything that we needed to do with automated payments and
again the the I pay online you know um but I don't get to spend tens to hundreds of millions of dollars at the statewide level to get that to actually happen so I think the the group the child support advisory group so this is going to be my third the election is this month actually this will be my but I'm running unopposed so I'll be on the
commission again um this will be my third uh goround with it um I think there are a lot of I'm I'm talking in a circle here. I think there are a lot of really good ideas and there's only so much that we can actually do. Um this, you know, we
do get 66% reimbursement from the feds, but the feds are very uh hawkish on making sure that we spend that money correctly. Um the state of New York built a system that they thought was going to be approved by the feds and then the feds said no. And so, you know, they spent, let's say, $100 million and
thought they were going to get 60 of it back and the feds said, "Nope, we don't. this isn't going to work for what we would have approved. And so they don't >> When was that? >> Yeah. That >> Yeah. Not too long before we got ours approved. So because that's why that's that's the reasoning I'm that before we got our money, the $28 million approved.
It's the reason that we're being given on why it's taking so long is we are and I I think appropriately so taking every step as a baby step to make sure, you know, um we're going to change the coding on the back end, send it to the feds, make sure the feds are okay with that, right? um we are going to make it
look this way and feel this way because we think that you know the new up and cominging college grads who are going to be child support workers someday feel more comfortable in it send it to the feds make sure the feds seem you know feel make sure that they think it's okay to make sure that all gets approved so I kind of tongue and cheek said it's the
way government works government doesn't always work solely but in this case it is working very slowly it's taking years to to get a new system it's I know system modernization is on the forefront of a lot of a lot of different systems that are happening and and ours is just another one of those and minute the the
staff down the the Minnesota IT staff they only have so many resources as well so I don't know how many people they can put towards this and how many hundreds of hours this is going to take um so so sorry to go back to your question um Commissioner Gamble I I think I think I'm heard I think there's only so much that can be done um a lot of the changes
that I've mentioned over the last handful of years including the ones today a lot of those have come from that child support advisory group the state used to again more so before I was even on the the child support advisor advisory commission used to make changes and we would only become aware of it through a bulletin, right? A bulletin
would come out and say here's the change and now you have to start doing this and we'd say what we nobody's talked to us about this. We didn't know this was happening. So at least now those conversations even if something is statutoily changed changing and we have to do something at least the conversation happens like during the legislative session so we have an idea
of hey six month months from now you're going to have to start doing something a little bit differently. Um so I appreciate that portion of it. Yeah. >> Thank you. All right. Any other questions? >> One quick question. Actually, two quick questions. When you talk about the
federal reimbursement, are you talking about title 4E reimbursement? >> We're we're 4D reimbursement. >> 4D. 4D. Okay. Thank you. >> 4D. Yep. >> Um, are there any magistrates on the advisory commission? >> There are not. This is our group.
>> There are other groups with with magistrates on them. Yeah. We have a group called MFSRC which is the MA Minnesota Families Services Recovery Council or something like that. Sorry, I'm blanking on it. Um they meet every well they meet multiple times but there's one big conference every year. There are magistrates who go to that um
including the chief magistrate whose name escapes me right now. Um anyway, they come um county attorneys come to those meetings, you know, to try to get some of that higher level um information. At the end of the day, the child support workers are still the ones
who write these orders. They're all reviewed by the county attorney's office and signed off on, right, to make sure we still work under the legal purview of the county attorney's office, but a lot of the work comes from the child support officers to begin with. And then if the magistrates to sorry to take your question further again, um when the magistrates have issues with certain
things, they're sure to to reach out to us um or give us a notice of deficiency on something and say, "Hey, I don't want you to write this this way. This isn't way I read the statute. You know, let's do it this way instead." And so that's kind of how we converse with the magistrates and get things done legally. >> Okay, great. Thank you.
>> You bet. >> Thank you so much for being here this morning, Dan. And thank you for all the work that you and your team do on behalf of Cook County. >> Thank you. >> Yeah. >> Thank you, Dan. >> You bet. Appreciate your work and thanks for your voice on the advisory. >> Yeah. Yeah. You bet. >> I enjoy it.
>> Thanks. >> All right. Uh we'll move on down to our next item which is summer preparedness presentation uh with Aby and Andrea. >> Morning guys. >> Good morning.
>> So how are you all doing this morning? >> Good. >> Good morning. >> Good. All excited about the summer. >> Yeah. >> It's nice out, right? It's feeling great. I mean, I, you know, I've always feel like for me, summer is
such a lovely time to look at because I don't have to worry about slipping. That's like my biggest thing. I'm so clumsy. >> Beware the mud, Obby. Beware the mud. >> You know, my my wife got me hiking shoes so I don't die, which I think is really
nice. Um, but that being said, that's her version of preparedness. I think our version of preparedness is a little bit different. >> Excuse me. This is Frank. Could we possibly get a microphone closer to Obby? >> Yes. >> Yep. I can word.
>> There you go. Can you hear me now? >> Much better. Thank you. >> Do you remember those commercials? Oh, yeah. >> Those were fun. >> Hate that they stopped doing those. >> Yeah. >> Great. Um, so I think our version of preparedness is a little bit different for you today. So today we'll be going
to be talking about summer preparedness. Uh especially talking about wildfires, smokes, and my personal favorite thing to talk about, which is tick prevention. Um so I'm going to go ahead and hand this over to Andrea to go ahead and talk
about uh wildfires first. Right. >> There you go. >> Good morning. >> Good morning. Um, as you might have noticed, this past Friday at the News Herald, we published um an article that we usually do in summertime to kind of
prepare um give education about summer preparedness from public health. So, what we are focusing on and what we what we try to highlight in the article is that summers in the northshore bring long days and outdoor recreation, but they also come with the
seasonal health risk, right? like wildfires, poor air quality, tickborn diseases and um these also are risk that are becoming uh more common due to our higher temperatures and prolonged uh dry
spells that we've been facing in the last few years. So regarding to wildfire prepar preparedness, what we like to highlight is that the summer wildfire risk is inco
county is usually um high as of right now. We are at um not as extreme um wildfire risk but every time that it rains it helps. However, we try to uh focus the
education regarding to make sure the households have uh prepared go bags that they sign up for code red code red alerts through the C county sheriff's office to receive emergency notifications including evacuation
notices and to stay informed via trusted local sources. And what we highlight in the county is WTIP community radio. They are our partners to communicate to the
public um when complex situations are happening and the information needs to travel fast and to uh in ways that our community is used to finding those news. So um
we also highlight that in in the event of evacuation the sheriff's office is the one that um issues that order and then they also do a physical notice. So they go doortodoor along with the fire
departments for the area that is getting evacuated. Then connected to wildfire, but this is more connected to poor air quality that comes with the wildfire smoke events that we have had experience
in the past few years. The science and the studies are showing that it's likely that we will continue to experience these poor air quality days based on the risk of fire in Canada because that air uh that smoke comes
from fires that are happening far away from here that we really don't have control over. So what we can do is prepare our community to have strategies how to mitigate the impact of those poor air quality days.
In the statistics that the MPCA showed in the last um emergency services conference is that Cook County actually has been one of the counties mostly affected by these air quality alerts. And we have reached the um what you can
see in your desk. we have reached the dark purple color um when we have had those events. So, it's important that people know what to do. Um there are some information that that they can be that can be found when
you look at the website, but mainly we encourage to figure it out how to have a break from that poor air quality and consider a clean air room in the home. They can do that with a box fan, kind of
like a do-it-yourself project, or you can get air purifiers to create that space and then have it as a resource when this poor air quality happens. It mostly affects children and pregnant
women and older adults and people with underlying health conditions. But when it reaches the levels the red, purple, and the dark red, it affects everyone. All right. Now, I'm going to let the
tickborn disease conversation. Who here likes to hike? >> Yeah. Okay, that that's great. I recently just discovered uh hiking because my wife likes it and um I
want to make her happy. So it's on the record now. You realize >> she knows it. >> Um well, something to look out for when it comes to hiking is bugs. Obviously,
we are all very irritated with the mosquitoes and the gnats that are just, you know, everywhere. Our screen door just looks like, you know, a scene where like the villain like throws their darts at like a board, just like these bugs just sticking out there. But something
to really look out for is ticks. So, there are two types of ticks commonly found in Minnesota. Uh, Andrea handed you a card. The ticks are on this card and they are two sized. The two types are the blacklegged tick or deer tick or
the uh dog tick or otherwise known as the wood tick. Wood ticks are a little bigger. Uh they're a little bit of a lighter shade of brown. Uh the deer ticks are a little smaller and darker in color. You've all probably heard of Lyme
disease. Those are usually carried by the uh deer ticks. The dog ticks carry other things. I'll get to that in a minute. If you get bitten by a tick, the most important thing that you can do is remove it
gently. Don't yank it off. Don't like uh smother it in petroleum jelly. I guess that's a thing people do. No, just take a tweezer or take your fingers if you really have to and go ahead and squeeze
as close to the skin as possible and gently pull off. You do that because if you tear off their head or if you just tear out the jaws, then it is still going to be in contact with your skin. The saliva is still going to be there
and the risk of infection is higher. If you take it out, then that means that you've got the tick off your skin, which is the point of it. Uh something that you can do to decrease your risk of tickborne illnesses is to uh treat your
clothing uh with stuff like peromethine. You can use repellents uh or you could just wear long sleeve clothes. That really tends to help. Make sure that if you go on a hike afterwards, you check your clothes
and you wash them in high heat if you are in an area where there might be a lot of ticks. Not all ticks carry diseases, but if the infection occurs, symptoms usually develop one month after the bite. Lyme disease starts out like flu-l like
symptoms, and sometimes you'll see the red ring or bull's eyee mark where the tick bit you. Uh so if you see any of those symptoms, you want to contact your health care provider. they will most likely start you on a medication called
deoxxycyc. That will help get rid of the infection if caught soon enough. The most important thing that you can do is try and get it caught early. Now, just because a tick doesn't have Lyme disease doesn't mean that it might not carry
something else. They tend to like to carry diseases, these little guys. So, uh the blacklegged ticks can also carry something called a nap. and >> you want to do it. >> Anaposis.
>> Anapomosis and uh Babisiosis, which is just super fun. Thankfully, the the dog ticks have much more uh fun names to pronounce, which is Rocky Spot Mountain fever. Granted, that's not very common in Minnesota. You're most likely going to find that in place like North and
South Carolina. But they can also carry stuff like tuleria and tick paralysis. So if you get bitten by a tick, keep an eye out for symptoms. If you get any symptoms, contact your health provider. These nifty little cards will tell you the dos and don'ts when it comes to tick
prevention and getting rid of ticks. I recommend you follow them, but if you ever have any questions, you can always contact your local health public health experts. We also have these materials available for the public in our office. So if you're looking to have materials for
your organization or a part of the community, you can get in touch with Andrea and she has access to those through the Department of Health. >> All right. Uh are we do we still have a um tick drop at the clinic? Do we know?
>> Well, no, they don't have that right now. I don't believe so, but that was a service that um Grand Portage was providing and they had the the clinic listed as a site. I can check with um Grand Portage Health Services and report back in July. >> Thank you. They had some really
interesting findings regarding uh percentage of ticks of percentage of different ticks with different diseases. Um with the deer tick, the blacklegged tick being the most dangerous. I mean both because of its size and then also I
think because of the types of diseases. >> There's one thing I want to note regarding to Lyme disease in ticks. Something that we discussed with a regional epidem epidemiologist. She u emphasizes that for the public to
understand that a Lyme disease is transmitted only after a dick has been attached for more than 24 hours. >> Specific for Lyme disease. the other ones the papilliosis or the those could
take less time but the Lyme disease which is the one that it has more severe impact it has to be 24 hours so that's something I try to remind people to some people like uh you know would say oh I found a tig oh does it have a ring I
mean like the ring will appear days after >> when the infection has uh spread through the body and then the skin is going to have a reaction So it won't happen like as you have the tick the ring around and all of that that happens later. So
that's important to >> thank you >> keep in mind >> and it's very important that you do not wait for the red ring of disease to show up on your skin. If you have had a tick on your body for more than 24 hours, it
is best to go seek care early if you start showing symptoms because the sooner that you can catch the infections when they become symptomatic, the less likely you are to have long-term side effects. This is a personal thing for me. My dad got dyme disease. Um, he didn't notice that he
had the red ring. he didn't notice that he got the symptoms as strongly as others might have and he ended up having long-term side effects for it. So, um it's a it's a real thing that can cause real problems for real folk and uh so be
careful out there. My wife actually just found a deer tick on her back the other day and she said, "Don't worry, I collapsed I I made sure to remove it properly and I alcohol swapped the area because I read the article. I didn't tell her to. I promise. So,
>> well, thank you so much. Um, we are going to be doing some tableabling education uh in a series of social media post. So, we will be hopeing uh partnering with Commissioner Sullivan at the canoe races. We're also going to
have a booth at the fisherman's picnic and we are also going to go to the open house at the west end for emergency preparedness August 15th. Great. >> Thank you, Avi. Thank you, Andrea. Great
information, great reminder, um, and great article. So, thank you so much for presenting. >> Any any questions before, uh, before they take off? Frank has one. Okay. Please.
>> Yeah. Thank you. Um, this is my uh first opportunity to to welcome welcome Avi. Um and my own background is in public health. So I totally respect what you do and look forward to uh to working with you uh and along with the whole board into the future. Great information.
Absolutely great information. This is what we used to call evergreen information. You create it once and it's always relevant. But just because we know it, you've told the people here and I know that you have a an outreach campaign to spread that word. I would encourage you to continue as much to as
many um through as many channels as you possibly can to bring this message to our residents, to our visitors. Um this is certainly a case where an ounce of prevention is worth many dollars of cure and an ounce of education can save not
only lives and and morbidity but also uh also also healthcare dollars. So, I think you're doing a great job and I just encourage you to reach out. Certainly, all all the social media, the websites are all great, but there's still a huge section of our community that's not that doesn't regularly follow
uh all of these things online. So, anything you can do, um, again, create it once and then it's it's it's available for years. Um, I strongly encourage you to do print and posters and inserts and anything that you can uh to to spread
that educational material. Thank you very much again for your work. >> Thank you, Frank. >> Thank you so much. And we will keep that in mind as we uh as we continue our prevention efforts when it comes to summer preparedness. Thank you so much.
>> Have great days. >> Thank you. I'll move on to item five is our director reports starting with staff updates and then also agency updates. Grace. >> All right. Um I'll start with staff
updates and I just want to give you all a word of warning that I have a lot of updates today. There's a lot happening and so I'll um >> we're ready for you. I will pause after I'll pause periodically so that you don't get to just hear a big block of me
talking and uh I'll leave time for comment in between in questions. So I'll start with staffing and HR updates. Uh Marie Marina Fujimoto, our adult mental health case manager, had her last day with PHS on May 29th. We continue to
have the adult mental health case manager position open until filled. Uh, our behavioral health team at the moment is extremely stretched due to being short staffed. Uh, big thanks to our adult services team and our children's mental health case manager
for taking on adult mental health case management clients in the interim. Um, additionally, Sarah Eisenrich, who was our temporary staff serving as the mobile crisis responder with PHS, had her last day on June 8th. Moving into
related updates for mobile crisis response. Starting on June 1st, our mobile crisis response shifted to teleaalth rather than in person with Brightwater taking on 247 call. This had previously been Monday through Friday
and after hours Monday through Friday after hours coverage and weekend coverage through Brightwater. The reason for this change is because with our limited staffing in the department and particularly within our behavioral health team, we simply did not have the capacity to support
inerson response within PHS. Even a slight increase in call volume put us over capacity to respond in person. Uh with the planned move of the mobile crisis response program to first call for help and the temporary mobile crisis
responder position scheduled to end soon. This decision supports our focus on successfully moving the service to our partners with first call for help toward what we hope will become 247 inerson response rather than uh
extending our limited resources to continue the previous program model with inperson Monday through Thursday during business hours. Um on that note, CR and Isla, the directors of First Call for Help are here in Cook County all week. They're
meeting with local partners about the transition of the program. I put at all of the spots a flyer for an open house which is scheduled for tomorrow from 3:30 to 5 at the community center which is a chance for people to learn more
about the program transition first call for help. Um, if folks are interested in learning about what it would mean to be a mobile crisis responder, that's an opportunity for uh folks to connect with CRE, Isa, and myself while they're here
this week. Um, First Call for Help plans to return to Cook County multiple times in the coming months in order to successfully build a locally based program. We will continue within PHS to facilitate the
coordinated crisis response team and support our partners at first call in building out a successful program. So I think that'll be my first pause before going on. So that's the the HR staffing updates and also updates on
mobile crisis. Uh any questions on that before I move on? >> Commissioner Gamble. >> Thank you, Mr. Chair. I have a question. The turnover that we see, there's so many different things that affect it. Um, and understanding that helps us just
to try to, you know, prevent that or to make sure that we're bringing in people that are equipped to be able to handle the the stresses. I would say that there are a lot of people that are drawn to public health human services because of their empathy and their intention of
coming alongside and helping people and u sometimes the the the book work and the requirements that are part of the position they didn't anticipate.
So you can take an individual who's profiled to be an excellent accountant and you can take an individual that's profiled to be very personable and um sometimes those two disciplines that have to exist in one person in public
health human services becomes problematic. My question is um in as far as Cook County when you're talking to your peers and you're just looking at the industry overall
um how do we compare in that turnover ratio and if you see that there's something that's a disparity between what's happening elsewhere and what's happening here then trying to understand that. Um but if it just nature of you
know the nature of the work then it's something you're constantly dealing with. So that'd be my question. >> Sure. >> Administrator trouble. >> So I have one thing to add on that and then I'd love to hear from our director as well but when Megan Mo was um doing the organizational assessment for us.
One of the things that she had mentioned is that the turnover is typically the highest within child protection and behavioral health. Um and I think that from her perspective what she had shared is it's because of the the nature of the work it's very challenging seeing some
of the challenges um that families and individuals face and it can lead to a high high level or degree of turnover. So just wanted to make sure that I shared that since that's something that we learned from Megan Mo as she was working with us. >> Yes, absolutely. I think that mirrors
what we've seen locally. Um, I think one thing that's unique, um, I I do say I think across the sector there are challenges with with turnover. Um, I also think there are some unique factors in Cook County. One of which is just our size. You know, if you're in a larger
county with a larger staff and you have a certain percentage of turnover, you still have a certain percentage of of people there to pass on the the knowledge and experience that they've gathered. And in a smaller county with fewer people on a team, that percentage
can can be felt much more acutely just because we have fewer people in our department than you would even in a county like Carlton. Um, and so that's one factor. Um, I do the next topic in my report was actually considering reorganization and that does talk speak
to some of your questions about our turnover rates. So, um I might just keep going with that part of my update and hopefully that'll speak to it as well. >> Ask a followup and that would be that >> uh for these individuals, are we now
conducting exit interviews? >> There's always a um HR conducts exit interviews with individuals when they leave. It's not required, but it's always offered. So, we do have information gathering when somebody leaves the agency. Yeah.
>> Um, and so we are keeping track of, you know, reasons why people are are leaving and using that as a opportunity for us to learn and reflect on what we can do to improve retention. And that's not just in PHS, that's across the county. >> Yeah, that's good.
>> So, okay. So, one of the other topics in Megan Mo's report was different options for reorganizing PHS. And that's something that I've been thinking about quite a bit over the past months. And I'm to the point at now where um I'm
gathering feedback from staff while I'm also closely studying those recommendations in Megan Mo's report. Um and so I've come up with some draft ideas. At this point it's purely informational. As I say, we're in an
information gathering stage where I'm looking at options, talking with staff, collecting feedback. Um, and so I wanted to bring a few points to you all just so that you know where I'm at with thinking about reorganization. This is something
that I'll continue to bring to our PHS board meetings as this process evolves, but I don't want it to feel like it's a surprise at the point that we have um, you know, a new position description, for example. I want you to know kind of what my thought process is along the
way. Um, so some of the considerations for reorganizing, what are the goals of of thinking about this? Um, ensuring oversight and accountability within our department. I think that's just crucial. Um, creating a structure that supports
staff and aids with retention. That's a key goal of looking at our structure. Um, and also keeping fiscal responsibility at the forefront. Um, in that vein, um, I will say that
the ideas I'm considering right now do not add new positions to the department and we may reduce the number of positions by looking really closely at two to three vacancies that have not been filled in over a year within our department.
um some of the positions in in my thinking would some of them are vacant, some of them are filled, but would shift in their scope and their title to better meet the needs within our department. So some examples of that within social
services, the model would include one manager providing oversight across the three social service teams, adult services, children family services, and behavioral health. One of the things in Megan Mo's report was the idea of having a career ladder
or some opportunities for internal growth within the department. And the way I've been thinking about that is by integrating lead worker roles within the different teams. So a lead worker would be slightly different from a supervisor. Um they would work under a supervisor or
a manager, but their positions would require a greater degree of experience and expertise. They would take the lead on complex projects or cases and they'd also assist with staff training and mentorship as we bring new staff on board.
Um, a few specific positions that would shift in title and scope. One of the public health educator positions would shift to becoming a public health planner position that recognizes the need for assessment and planning as a foundational responsibility within our
governmental public health system. the executive administrative assistant role. We're looking at shifting into a systems administrator role that would assist with information management and support for staff in accessing and learning the multiple software systems
required in human services. We're looking at uh the intake function for social services and at centralizing that function in two positions that would also spend time engaging in paraprofessional work such as a case
aid, a community health worker or a peer support specialist when they're not actively engaged in taking a social service intake. We're also looking at the fiscal supervisor role and um shifting that to be a fiscal
administrative manager role that also provides backup for the director uh in the instance that I am absent. Um and recognizes the key oversight role that this position plays in managing the agency's finances. So I know I myself am
a visual person and I just spoke quite a bit. Um, I'm hoping in July to come again with an update as to where we're at with the reorganization thought process that includes visuals so that it's easier to kind of conceptualize the
different changes that we're discussing at this point. But once again, I just want to reiterate that this is an information gathering phase where I'm having conversations with staff as to whether they feel like these ideas would work, whether they feel like they would
help us accomplish the goals that I stated initially. Um, and and just getting hearing them out as they're the people doing the work within our department on a day-to-day basis. So, that's where I'm at with thinking about
reorganization within PHS. Um, any questions on that before I move to additional topics? Like I said, it's just a really packed director's report today. Administrator, >> thank you. So, um, thank you for that,
Grace. An excellent job. Um, Grace has been partnering with HR and myself in looking at this as well. So, I just want to make sure the board is aware of that and um and like she said, really pulling in staff to hear their perspectives on
these changes and make sure that their their voices are part of the process. Um, the other piece I wanted to mention is we're also looking at all of the recommendations that Miss Moe's made in her report and how we can accomplish those recommendations and that several
of these changes are directly related to some of the items that she had mentioned and the the things that we need to shift and account for. So, I've I fully support the work that Grace is doing in this area. Yeah, I just wanted to say that I appreciate the approach uh and I greatly
appreciate just communicating the the ideas and and where we are at and and where you're looking to go. So, thank you for >> Absolutely. >> Uh Commissioner G. >> Yeah, thank you, Mr. Chair. Yeah, I I couldn't agree more um with the comments
and the affirmation. I mean, we've gone through uh quite the process in public health human services and I keep referring to it as a uh an example that could be a case study. This is how you
do it. When there when there's an identified challenge, problem, however you want to term that, what is your response to that? First is to identify and then to take a look. We brought somebody in that made recommendations and that was my initial question is how
are we connecting that investment in evaluation to direction? We've had some discussions, I'm sure it exists elsewhere with our advisory committee and uh sometimes
we find ourselves in a situation where uh our experience reshapes how we are going to formulate what we do. And there's a healthy way in that in which that happens and there's an unhealthy way where we're accommodating something
and we don't want to be in that position. We want to take what we're learning, what we've gathered through the advisory, what we're hearing from staff, from our human resource administrative position and all of this collective with identifying what our
goals are. As you have mentioned, it's a healthy process and um just really uh encourage the direction that we're going. It's it's healthy to be able to step back and say, are we doing the best that we can do? And we had uh northern
counties, we had a presentation from St. Louis County in their GIS department um this past week and they had a a a logo thing is like a star you'd see on on blue ribbon meets or whatever. It had that kind of look, but what it says be
the best you can be. And when they made their presentation, the first thing they said this is our direction. And we hear those words, but the substance of those words demonstrated what they presented. It just blew me away. And so I I encourage you focusing on the things
that you you what you want to be and what you want to deliver in services to our community. How can we best do that? And having all those collective voice and the advice that we're getting, you know, from the consult and things like that that we're connecting the dots on
that, it's just great. So, I continue to be u just affirming what we're what we're doing in in the department. I appreciate your leadership in that. >> Well, thank you, Commissioner Gamble. Like I said, this is not the last time you'll hear about reorganization
efforts, but I wanted to get the conversation started. Um Okay. >> And the and the main thing is is coming from the right place. >> Absolutely. >> Yeah. The direction that we're going is coming from a right place. and it's not motive because we have to adapt to
something we can't figure out. So, >> I think having Megan Mo's um report and expertise and really having the ability to continue to consult with her um in a kind of coaching relationship has been really helpful. So, I can share I've shared these ideas with her as well and
gotten her feedback on them. So I think that trying to use all the information that we've gathered and gather feedback from, you know, our HR department, our administrator and our staff within PHS, those are all important pieces of the puzzle as we figure out how to move
forward. So okay, I have um public health updates. So, Rosia Rivo, Rosio Rivas, our youth prevention specialist, is working with various youth groups over the summer on a multimedia project with Bear Witness Media. You'll see uh later on the agenda
there's a item that is related to the contract with Bear Witness. The intent of the project is to engage youth in media production while creating conversations about mental health, connection, and resilience. They're also aiming to create something authentic,
positive, and inspiring while showing how youth can make a difference in their community. Um, Andrea Orest was working with Sarah Waddle, our um community center director and extension educator to co-f facilitate the comet training, which is
changing our mental and emotional trajectory. They both trained as trainers this past spring and co-f facilitated a training at Cook County Higher Ed last Friday. It's a 2-hour interactive training that teaches community members how to reach out in a
meaningful, respectful, and supportive way to friends, neighbors, and colleagues in a time of need. Um, my next update is from the Thrive Together community resource directory website project. You may have seen the
media release that the county put out last week. The Thrive Together website is live. Um, there's also going to be a county connections article coming out on Friday talking about the resource directory along with a outreach campaign
that happens over the course of the next several months that includes social media, um, spots on radio, on boreal, and then also a mailer with a magnet to households throughout the county that'll come in the late summer, early fall. But we're really just trying to get the word
out to let people know that this resource directory is out there and it is a tool for all people to learn how to to learn what services are available in Cook County and to connect with those resources. So, it can be used by um
professional colleagues helping clients. It can also be used by anyone who is looking to know what's available in our community. Um the URL is thriveccn.org. I'll that'll be in the notes as well, but highly encourage you to take a look
at the site, spend some time exploring and let people know. I mean, I think the the resource is really only going to be as as good as it is utilized across the community. So, at this point, what we're looking for is to to really spread the word. I'm also planning to go on the
radio tomorrow morning to talk a little bit more about the resource directory site. Huge thanks to Betsy Blazedale who's one of our office support specialist case aids who did a tremendous amount of work in putting together and organizing the resources in
the site to Erica Turns who is maintaining the site over time and to Danielle our PIO communication specialist who has also played a really key role in communicating with our vendor helping coordinate submissions
from local photographers and bringing us all together to make updates over time. Um, our advisory councils. So, we had a joint meeting of our local mental health advisory council and our public health and human services advis advisory
council last Tuesday. We discussed a draft mission vision statement for a merged advisory council and reviewed the statutory requirements for PHS advisory councils and local mental health advisory councils. Andrea Orest is going to be leading a work group to ensure
that as we discuss merging, there still remains a focused effort to recognize um mental health and mental health supports in the community. Um we're going to be meeting again on Tuesday, July 14th at 1 p.m. to continue to discuss mission
vision bylaws for a merged group. At the point that those are complete, we will have a vote to formally merge. I'm not sure if that will happen in July or August. It depends on the the evolving conversation. We're also um we every year have a grant
making process that is facilitated by public health supervisor and includes a subcommittee of the public health and human services advisory council. That's the public health fund subcommittee. Um, and we're going to be reaching out to 2025 grantees for their annual reports
and getting that subcommittee back together to prepare for 2027 grant making. So, more to come in the in the following months about that. Any questions on public health updates, the Thrive Together website, or our
advisory councils? And then I'll move us into my last topic. >> What's the last topic? >> SNAP updates. >> Okay. Please commission >> just want to know to wait or whatever. I did have a question. I don't I'm not sure if you can answer it or not but in the financial report that we had in our
packet when we look at the mental health services under the collections that's significant. Can you give us a context to understand that 269% increase in collections? >> Yes. I believe that's related to an
estate recovery case that our um fiscal supervisor had been working on that came um came to a close in 2026. So that is the that is the reason for that increase. >> Yeah. And sometimes I mean when we're looking at budget for the county
departmentally whatever that there are revenues that come in and it's it's it's not finite as far as tracking things at an immediate level. But that's something that's out of the ordinary given the nature of what we were doing. >> Absolutely.
>> Yeah. And I appreciated Clement's work on that. That's >> Yes, I echo that. He's been doing phenomenal work with estate recovery. >> Thank you. >> Yep. >> All right. So, changes to SNAP. Um, I'm going to do my best to be clear and
succinct here because it's a big topic. So last summer, this board will remember that I did a presentation on um House Resolution One. It's also entitled the One Big Beautiful Bill Act. Um this is a federal this is federal legislation that
affects state and local government. There are changes in this bill related to both Medicaid and SNAP, and they don't happen all at once. You might remember from last year's presentation, they happen in a rolling basis over the course of several years.
Um, so I want to talk about specifically what changes in HR1 are related to SNAP. So, there's many policy changes that affect SNAP and those include changing how benefits are calculated, narrowing
eligibility for legal non-citizens, expanding work requirements for more groups, and shifting more costs onto state and local governments. And that last point is the one that I'm going to focus on today. So, SNAP, just a a
reminder, SNAP is what the acronym for the Supplemental Nutrition Assistance Program. This is a program that serves around 212 people in Cook County. Um the average benefit amount for a SNAP recipient nationally is around $6 a day
for food support. Um and there is an economic impact in the estimate that each dollar spent on SNAP benefits generates around $1.50 in local economic activity. And that's because making purchases in local grocery stores that creates jobs that creates additional
spending in the economy. That is how that $1 spent $1.50 in uh local economic activity. That's basically what that represents and that's a national calculation. So that's SNAP in a very
small nutshell. So, the cost shifts, um, there's a portion of these cost shifts that will go into effect October 1st, 2026. Um, we weren't sure exactly what this was going to look like until after the last
state legislative session, which is why the update is coming now. We knew something would change in October, but now we have a clearer sense of what exactly that will be. So with SNAP, the federal government
reimbures us 50% of the cost to administer the SNAP program. So we have staff within the county that administer the SNAP program on behalf of citizens participating in the program. Um and to
date the costs have been reimbursed at a rate of 50%. But with this change in legislation, that reimbursement rate will drop from 50% to 25%. So rather than uh the county paying that
50% administrative cost share, the county will now pay 75% of the administrative costs of um working with the SNAP program. There's an additional change that's slotted to occur at one year in the
future. So that's October 2027. Um, and that cost share is related to benefits. So, um, it's I'm going to try to again be very clear, but it's a little bit, um, I don't know, it's a
little bit complex. So, um, every state has what's called a payment error rate for SNAP. That can be an overpayment, that can be an underpayment, it can be something that a staff member miscalculated. could also be something that the client misrepresented or
omitted in an application. But um all of those errors are corrected, but they're also reported into uh state and federal systems. So every state has an er a payment error rate. Um and
based on what that percentage of is the payment error rate at the state level um state and local governments will be required to pay a percentage of the SNAP benefits. So to date the federal government has paid the entire cost of
the benefits that individuals participating in SNAP receive. But with this new legislation, depending on what the state's payment error rate is, um there will be a cost burden shifted to
state and local government. So our current payment error rate at the state level is 8.9%. It's lower than the national average, which is 10.9%. But at that 8.9% state and local governments would be
required to pay 10% of the SNAP benefit costs which were previously paid for by the federal government. So AMC and MAXA have done some cost estimates and I'm going to include the
AMC handout with my notes so that you all can see exactly kind of what I'm referencing. But I thought it would be helpful to verbally give you kind of the the general um sense of what these changes are. But they've done some projections on what these costs will
mean by county. So the administrative cost share the estimate for Cook County for 2027 on that, you know, instead of getting 50% reimbured, getting 25% reimbured.
um that let's see the total cost increase to Cook County for administrative costs with SNAP was projected to be $76,994 for the administrative cost share
associated with HR1 for Cook County. So that's cost that was previously being reimbursed by the federal government, but with this change in legislation will no longer be reimbursed by the federal government. So that's 2027
administrative costs with SNAP. Um, and then let's see. So actually I I misspoke. That's the administrative cost share and it includes the 10% benefit cost share. So
that's the maxa AMC estimate that the increased administrative cost share with SNAP and the 10% benefit cost share, the total increase to Cook County for 2027 is projected to be approximately $76,994. In the last state legislative session,
Minnesota passed a one-time appropriation to counties to offset cost shifts to the counties associated with HR1. So the estimate for Cook County with this one-time appropriation is $30,000
875. So, the difference is roughly 46,000 in a cost increase to the to Cook County that would not be covered by that one-time state appropriation. Um, so it's a little bit complicated,
but I did my best to explain. I'm happy to welcome questions. AMC and Max also have some key messages for local um elected officials and local leaders to remember. One of the things um is that there's there's a push to delay
implementation. Um that would be a federal push. That's something that AMC is discussing. Talking about Minnesota is somewhat unique. We're one of only three states in the country in which counties pay a portion of the administrative cost for SNAP. So there are other models in other
states and our state is somewhat unique. Um there is a sense that these federal cost shifts will create an ongoing financial burden for counties the way that the legislation is written right now. The one-time funding is helpful, but again, this is a long-term policy
shift. So, this is a long-term cost shift that we're looking at. I it is worth noting that counties and states are partnering to improve that payment error rate, which would reduce the benefit share in the future. Um,
and there were upgrades to technological systems and investments in the last state legislative session, but these don't happen overnight. Modernizing technological systems takes time. Um, and I think just to end on a positive
note, uh, AMC and MAXA continue to be very committed to SNAP. It is a very important program. It does reduce hunger. It does support local economies. However, this change in legislation does create a change in cost burden for counties and that is something that we
have a better sense of after the last state legislative session. So, I will include that resource in the minutes from this meeting. Um, and I'm happy to take questions from the board now or in the future as we consider what this will
look like for Cook County. Do you know uh what the next tier is for the error rates and what percentage would be a cost share at that next lowest lower red >> pull that up right now
>> and if it's not easier there that's that's fine but that's an initial question I had and then also just for our perspective um little bit less for this first year but it sounds like uh in the upcoming year that's roughly a half a percentage of our levy.
>> Um, just to give us some perspective there, the last number I had heard and I shared with Grace was something around 26,000 total. So, this is a significant increase from that. >> Um, but um, >> so could be a lot worse as well.
>> Um, the payment error rate right now we're in the 8 to 10% range. That's the 10% benefit cost share. the the the 6 to 8% payment error rate is 5% benefit cost share
>> and then if there is less than a 6% payment error rate there's a 0% cost share for the benefits um >> do you know um does I'm assuming fraud is included in the error rate is that
>> gosh >> fake ass assumption >> it's fake I know I mean I know that uh fraud and SNAP in particular the rates are very low. I'd have to look into the research to give you an exact quote for
you know what is the research on fraud in the SNAP program. Um I'm I'm not sure if I can answer that question fully, but I I know it's um it includes overpayments, underpayments, worker error, client error. Um that's
generally kind of what the payment error rate >> captures. >> Um so >> yeah and um the the timeline for these changes and more detail is in that AMC handout. I just wanted to give you some context because if you look at it
>> um at first glance it it has quite a bit of information but that is the background. This is coming out of HR1 and this is part of that kind of rolling implementation of policy changes that are included in that bill. So, >> thank you, >> Commissioner G.
>> Thank you, Mr. Chair. Um, so just to to be clear then we were being reimbursed for the administrative costs at 50% but now that's changed so it's going to be 75%. will be reimbursed at 25%
we're going to have to correct. Yeah. And that's in October. >> And then we have because of our error rate, we're at a 10% of having to pay the the benefit. And that combined is roughly about 76,000. But because the state has a one-time appropriation,
it'll bring it into 40ome,000. So when we're looking at the budget, we're going to be $40,000 more. uh realizing that whatever our numbers were in 2025 2024 that there's going to
be a variable with changing numbers of participants but there's also because the HR1 going to be the additional 40ome thousand that we'll be looking at in the budget. >> Yes. And when we do our budget presentation, I'll make sure that Plman and I are clearly pointing out where
this applies in our budget for 2027 because again, it's still kind of a rolling implementation. We have a piece in effect October 2026. The bigger piece, which is the benefit share, won't go into effect until October 2027. So
both of those um points in time will be taken into effect as we create our budget for 2027. Yeah, we have uh following this meeting, we'll be having our committee of the whole and soil and water will be presenting and we
can see uh the effects of legislation as it impacts revenues and how we have to adjust accordingly when we've got less to do increasingly more so to speak. So appreciate the information and keeping
us aware. >> Yeah, absolutely. And like I said, feel free to ask questions anytime. >> Any other questions, Grace? Okay, >> that's the last item in my director's report. Thanks for sticking with me
there. >> Thank you for communicating. Oh, Frank, did you have anything? I'm sorry, I didn't look at the screen. Okay. Um All right. Uh we'll move on to items for board action. Uh just the one. And this is the um contract for the youth
engagement um project that Grace had mentioned. Um anything more you want to say to Grace or do we have any questions about >> I'll just add that that is entirely funded through the substance misuse and suicide prevention grant as an and it's included in our in our work plan for
that grant. >> Great. Uh Commissioner Selvin. >> Thank you, Mr. Chair. Um, Grace, a question as um youth are participating in this um endeavor. Um is PHS the one that's in
charge of releases, permissions, and that type of thing? >> Yes. So, we have all of those forms created and um we are the ones taking the lead on that portion. >> All right. Thank you. >> Mr. Mr. Chair, we're looking for a motion to support uh motion to support
the um public health human services youth engagement video project production uh contract uh which is fully funded through the Minnesota Department of Health. Thank you, Commissioner Gamble. We have a motion. Is there support?
>> Commissioner White support. >> Thank you. We have a motion from Commissioner Gamble, support from Commissioner White. Uh further discussion hearing or saying none. All those in favor? >> I >> I uh those opposed. >> We need a roll call since he's virtual as well.
>> Ah, touche. Touche. Uh we'll do a roll call vote. Uh Frank. >> I vote I. >> Thank you. Commissioner Sullivan >> I. >> Commissioner Gamble. >> I. >> Commissioner Mills is I. Commissioner White. >> I. >> Commissioner Stley. >> Hi.
>> We have our unanimous vote. Thank you very much. Um, that moves us down to I'm sorry. >> Hi, >> boy. >> Can I add one thing before? >> Yes, please. >> I just got a message that Sawtooth Mountain Clinic is indeed receiving
ticks. So, if you have a tick and you want to bring it, I mean, >> Oh, yeah. Put it in tape. But if you want to drop off a tick at the clinic, they do pass them on to Grand Portage and then Grand Portage um screens them
for to see if they're carrying any diseases, which is actually a really important source of local data as to what our tick population is carrying. >> Incredible local information. And it also relates to our wildlife move all all >> things. But that means we have to forgo
the pleasure of >> smashing it between two rocks or starting a fire. >> I mean, if you find enough tips, there could be enough for both things, right? If you could you could bring some to the clinic and then dispose of others in
different ways. >> They don't have to be alive. >> So you can smash it and then bagg it, you know? >> Yeah. They're pretty like all over. >> Yeah, there's ways. >> Uh, okay. Let's move on to committee reports. Uh, we have a little bit of
time here, so that's that's nice. Uh, the first one is the active living steering committee. Uh, Commissioner White. >> Well, and I talked about that last time a little bit. A lot of it has to do with trail development um up by the
the view. Is that what it's called? >> Up on the hill and doing that. And Robbie's Robbie has many details on that. So, it's it's going to be um the question is do we do it at some point a bridge >> or a tunnel?
>> Oh. under the gunflint trail because you absolutely cannot ask a loaded semi to slow down or going either way. So that that was interesting. But
>> and for the um for the trail that's going to go from uh the highway to the recycle center, that won't need a a bridge or a tunn. >> And that's this year yet, right? Is it >> correct? Yes. Yes. >> Yeah.
>> Good deal. Thank you. Uh, next one is AEOA. Uh, Commissioner White, >> they have a meeting tomorrow and I am tomorrow. >> Okay. >> And it can be zoomed and I did send out a request. Can somebody take that Zoom meeting?
>> Oh. Um, >> it's >> I bet you I'm the alternate and I bet I can take that Zoom meeting. >> Remember what's tomorrow? >> Tomorrow is our in the morning. in the morning and this starts at noon. The Zoom meetings. No, wait. I just added my
>> I think we're done at done by noon. >> Send them a notice. Explain why. >> And because it's still hanging out there, our bill or their invoice to us about helping to support >> um >> their construction. We have not come up
with an answer for that yet. >> But I would like to report about the AEOA buses which has to do with that. They actually do not have a hard and fast rule about the five mile limit because they actually delivered uh three miles
off the highway to our doorstep. Um a person just getting out of the hospital and they just said, "Yeah, I mean it was the Grand Portage bus that it worked out in." >> Yeah. >> And the bus has no shocks. >> Oh,
>> just so you know. >> Yeah. Heard of that. So that was really really a nice individually and it was a nice gesture to do that. >> Yeah, absolutely. Well, it's encouraging for other options as well.
>> And I do know that there have been other instances where people have needed they're beyond the five mile limit but they and maybe only by half a mile. >> Sure. >> And so they were able to get to Grand Marray to the hospital. So >> excellent.
Um the next item is Arrowhead Health Alliance. Also, Commissioner White. >> Oh, I just attended that meeting and they're doing quite well. Uh they are positioning positioning themselves for
the eventual um retirement of their administrator who's been there forever. But it might be two years or three years, but just in case he drops dead from something, they're getting >> quote unquote um he looks to be in good health.
>> Yeah. >> That their finances and their um different grant sources are covering everything that they need at this point. So, it's a healthy organization focusing on mental health and behavioral health.
And um before being in this position, one I never thought about how mentally ill everybody in this world is. I mean, but two, the number of resources. I mean, even locally, it it's it's
it's almost overwhelming. Maybe it's not enough, but it's very comforting, just like emergency services is very comforting in this county. So, um, way to go Cook County.
>> Thank you. Uh, Arrowhead Regional Corrections, Commissioner Gamble, >> that's been moved up to Thursday because Friday is >> Junth. >> Junth. So, uh, we'll be meeting Thursday. >> Okay.
uh community health board. We did meet um our our doctor's report this time was on um measles uh and Ebola
and um very stark. Um so far the United States has more measles cases than all of last year. Um, it has not been officially uh I mean
maybe it has by now, but it has not been officially uh considered endemic or we I forget what the term is. Frank, I'm sure you know just about having that zero there's like zero >> immunity. >> So there's a designation um that a
country can get that says that they've they've yeah they have eliminated measles. So we have that designation and we will lose that designation. We haven't lost it yet in November though, I think. >> But it's it's projected that we will
lose that designation within the year due to the increased activity of measles >> in the US. >> Yeah, >> I'm not a betting man, but I bet it'll be after November that we get that we lose that designation. Um, and then
yeah, the Ebola uh statistics were also uh just incredibly shocking. Um, uh, I believe it's a 30 to 50% mortality rate. Um, and then, uh,
we had a graph showing the previous outbreaks, the historic outbreaks, and this one, and it was a graph over a 100 days. uh and they were, you know, had a a decent slope to them, but this outbreak
is almost just straight up. Um, and I believe the numbers are greater than all of the other outbreaks combined and just going up. There have been American doctors uh that have been
denied uh re-entry into the United States and also treatments have been denied from the United States to uh the Congo. Um and so we have American doctors out
there just just hanging out uh without coverage from our country or the support from our country and it was just really really terrible. So that really uh gives pause to other doctors to
you know provide services uh as well because if if if they're going to be put in that same situation it just is really tough. So, uh very very discouraging. Um also, um oh, and there was one other
disease too that he that he covered and I wish I remembered what it was now, but it was it was uh disturbing because all three of the diseases, the symptoms start out as like headache, bodyachches, you know, dizzy, like all very common
viral uh symptoms. And so it's Oh, the other one was haunt virus. >> Um, and that one was also very scary. Um, I'm sorry, maybe that has the 30 to 50% mortality. Um anyways, all of them start out with those kind of
vague I'm not feeling well and you know uh it's just really hard to you know it could be co you know it's it's just hard to know what's what's going on and if you should go in and when you should go in and of course our risk for Ebola or haunt virus in Cook County is very very
slim in in Minnesota but um it's just interesting this is the first haunt virus that or it's the only haunt virus I that allows from human to human spread. Um, and that originated I think in Argentina, an Argentinian cruise. And
I think there is 23 different >> country pe 23 uh people from 23 different countries on that cruise. And then uh they were not I think there was one death and then maybe a second death of
the spouse of the initial one, but uh they were not quarantined once they were landed. It was just like okay, there you go everybody. And so contact tracing then has been a bear. Um and I did read some update um in the news um that we do
have a person in the United States that is still under quarantine. Um they'll pass the CDC's recommendation, but I guess just to play it extra safer. I don't know what's going there, but it's very very scary. Commissioner White, >> do we have a an approved or or
intervention to help people not die and then to prevent them from do they develop um an antibodies to it so they do not get reinfected. >> Are you speaking about haunted virus specifically?
So >> there's not a vaccine which >> yeah I will say something that is um challenging is hearing about something like Ebola or HANA virus and there so there are not at this point confirmed
cases within the US but whenever there's an outbreak like this anywhere in the world the whole public health system goes on alert and at uh the state level at the regional level like staff get updates and can push updates to clinical
partners about different disease outbreaks. Um the global public health system is not as robust as it was even a few years ago during CO and that is a challenge because there is some
interconnectedness between our local and state health system and global health systems that monitor these types of outbreaks. Um but you know we continue to do the best we can with the information that we have and um and like I said share that information with
clinical partners and the the the point at which we're talking about medication interventions um or vaccines that typically those messages get pushed out to healthcare providers along with what questions to ask about travel history and what
symptoms to look out for based on the answers that someone gives. So it's not exactly an answer to your question, but there is this system and it went into effect at the beginning of co um and you know it's it goes into effect every time something like this happens somewhere in
the world that everyone learns to the basics of the disease, what to look for, how spread is occurring, what the characteristics of that spread are. Um, and so it's even though we don't have
cases, you know, Andrea, who is just here as our preparedness coordinator, she's also our disease prevention and control coordinator. So, she sits in on those meetings regularly to learn what the situation is, even if it appears to be a very low risk, because we know that
those situations can change. We're not anticipating that with any of these outbreaks, but it's still best practice to remain informed. Um, Frank had a question or comment. >> Yeah, just just a comment, Commissioner.
>> Um, hold on one sec. >> Uh, with regard to Han virus that is endemic to the to the southwest, uh, carried by mainly by rodent droppings, but that is present in the US.
uh Ebola of course is not and first line defense there is simply going to be surveillance of cases as they come in. The big elephant in the room is measles. >> Extremely contagious,
reaching the point or accelerating toward the point where her immunity is no longer effective and most and and there is a vaccine easily available but we all know the uh history of that.
>> Thank you. Yeah. Yeah. The contagious as how contagious they are is was also a interesting thing. Measles crazy contagious. Ebola not as contagious but way more deadly. And then hontovirus. Yeah, I've been aware of haunt viruses
from my rustic life and um being aware of rodent droppings and and that but haven't heard of anyone. And then just that human to human spread is the I thought kind of the twist on this particular strain. So,
but um yeah, so that was very informative and and eye opening. Um let's move on to the local advisory council for mental health. Rana is not here. Grace gave a update. So maybe we can just pass on that. Council on Aging, Commissioner White,
>> more just more of the same. They continue to to seek u grant dollars and they they will be coming. They want to do another presentation to the board. >> Okay. with the administrators when it would best work out for um
for doing our budget. Good. >> Uh Commissioner Sullivan, emergency preparedness. >> Um we did meet last week and primarily had Warren Lelant from Lake County do an afteraction discussion with us about the
fire, the Stewart River fire in Lake County. And um as I've said before um if you drive along Highway 61 from Two Harbors towards Grand Marray towards Cook County, that is the best advertisement for Firewise we will ever
see. >> Um it's very unfortunate and very sad, but please follow our Firewise principles and um >> seek support from Firewise if you need it. >> Thank you. >> Thank you. Uh any updates from Niko
you'd like to share? Commissioner Sterling? >> Um just basically working on the Medicaid part and the responsibility that's coming onto the county's eligibility and how do you enforce it. So continuing with other people in other states, how they're going to help us do it, too.
>> So that's it. >> Thank you. Uh anything from Jet Commissioner Gamble? N uh Northshore Collaborative? I did not either I already I think we'll pass on that one.
Either I already updated or there isn't a whole lot to update there just that we're spending down our our reserve and the funds are not coming in um like they used to. So that's kind of the the strategy there. Uh also had an update regarding our PHS advisory council from
Grace. So probably pass on that. and then the food access council. Um, a lot to update there. uh a lot of good coordination and um
uh the most exciting thing in my mind is there's been funding received a grant for um the leftovers from the farmers market to be purchased and then given to the food
shelf. And I just think that is fantastic and such a a good step. Um and that type of thing. And then also hearing updates on the food is medicine uh prescription um pilot. Um just that's uh developing
and moving forward and um I think it's been a while now I guess couple weeks. Um but the last I had heard there was six people signed up out of I think the 11 they're aiming for. Um so maybe there's more by now. I don't know. But I think that's a really great program that
hopefully will be helping people. Um I also was hoping we could make connections just with our inhome supports because um part of the challenge too can just be it's one thing for people to get this fresh healthy food. It's another thing to >> Yeah. prepare it, cook it, you know. So
and there is support for that too. So I'm hoping all these things can align and we'll be doing some real good there. But um anything else for the good of the order? >> Oh, Frank's something. >> Oh, Frank, sorry.
>> Six out of the Yeah, >> go ahead. >> Six out of the 11. I'm sorry. Was that for members of the food access council? They were looking for 11 members and you have six signed up so far. >> No, that was the food is medicine RX the prescription uh program.
>> Medicine. Ah, okay. >> Okay. Thank you. And uh with regard to the advisory council, um Grace gave an excellent summary of the uh process of merging the public health and human services advisory council with the mental health advisory council and I fully support that and I think it's
going to go a great way toward uh using the uh the volunteer resources that we have more effectively and just give fully support to this effort. >> Thank you. >> Thank you. >> Great to hear. All right. Well, not seeing anyone else chomping at
the bit to speak, so I'll call us adjourned. Thank you. >> Thank you, >> David. I forwarded the uh >> Oh, from Jessica Zolola. >> Thank you. I think I should be able to Well, we'll see how our Wednesday goes, I guess.
>> Right. And I just I don't have enough Oh, great. energy to come up, >> but I am going to be >> at the thing Wednesday morning. >> Great. >> Yeah, I forgot about that. Well, normally I was like, it should work, right?