Are we on camera? We can >> you can see us. >> Yeah. >> Yeah. >> Okay. >> Wow, that was easy. >> That's [laughter] some good uh good 8 a.m. problem solving for [laughter]
>> taking notes. >> Yeah, just do it again next time. All >> right, we are live. >> We're live. Excellent. Um, good morning everyone. I'd like to call this meeting of the Cook County Public Health Human Services Board to order on this Tuesday, January 20th at 8
44 a.m. Worked through some technical issues and now we're ready to roll. Uh, first item is uh the call to order and next is election of the 2026 PHS board officers. Um, first one is the election of chair. Are there any uh commissioners
who would like to be chair or would anyone like to nominate someone who would like to be chair? Commissioner Sullivan, Commissioner Gamble. >> I would like to nominate Commissioner Mills to continue in the role. Um just as at our um county board of commissioners. I think a little continuity would go a long way at this
time. >> Support. You passed the technology portion [laughter] of the >> Okay. >> Pop quiz. >> That was your nomination or >> Yeah, I'm supporting her [laughter] nomination. Um, are there any other nominations? Are there any other nominations?
Are there any other nominations? Hearing no other nominations, I'll close the nominations and we'll have a vote for Commissioner Mills to be chair of the PHS board for 2026. All those in favor? >> I.
>> Those opposed? Same sign. Motion passes unanimously. Thank you all for your uh trust and support. And now on to the election of vice chair. Uh is there any commissioner who would like to be vice chair or uh are there any nominations
for a commissioner to be vice chair? Not everyone at once. [laughter] I'll make a motion to have Gary Gamble be the vice chair if he is interested. >> That's fine. >> Good. >> Pick somebody. >> Yeah. Any other nominations?
Any other nominations? Any other nominations? Hearing or seeing none, I'll close the nominations for vice chair. I will call the vote for uh the uh vice chair as uh commissioner Gary Gamble for 2026 public health human
services board. All those in favor >> I >> I >> I >> opposed. Motion [clears throat] passes unanimously. Thank you. >> Uh moving on to item three is the approval of the consent agenda. Our consent agenda has our meeting agenda,
the minutes from December, financial report, uh year-end donations report, abstracts and bills, uh uh renewal of um purchase of service agreement with Northshore Health for Home Healthc Care Services. Another renewal of contract
addendums with Satos Mountain Clinic. Another renewal of purchase of service agreement with Arrowhead Health Alliance for adult mental health services. and then another renewal of purchase of service agreement with Airhead Health Alliance for mobile crisis response services. Are there any items a
commissioner would like to pull to discuss or uh any adjustments to our agenda? >> Commissioner Gamble. >> Yes, thank you. Um I would like to pull C, which is the financial report, please. >> All right.
Anything else? All right. >> Oh, yeah. Oh, yes. Thank you, Frank. Yes, >> Mr. Chair. >> Yep. >> Thank you. U I would just I I had a couple questions about the mobile crisis response center. >> That's item I
>> I don't have that in front of me. >> Oh, okay. Yeah, it is. Okay, it's item. That's fine. Thank you, Frank. Uh any other uh items? >> Commissioner Gamble. >> Yeah, thank you, Mr. Chair. I would make a motion to approve the consent agenda
with the adjusted noted item C and I. >> Thank you, Commissioner Gamble. We have a motion. Is there support? >> Support. >> Thank you, Commissioner Sullivan. Motion. Yep. Thank you, Frank. Uh, we have a motion and support. Uh, all those in favor? >> I >> I opposed. >> I [clears throat]
>> Same sign. Thank you. Uh, Frank, just to be clear, I'll talk slower and move slower. That was an uh I in favor. >> Yes. Okay. Thank you. There's just a little bit of a delay, so I'll I'll take that into consideration, but uh that was
unanimous approval. Um thank you. Let's uh talk about the financial report. >> Uh thank you, Mr. Chair. I I just wanted to point out or not point out but ask the question relative to the financial
report. This is a financial report year to date through December 31st, 2025. And it reflects the expenditures as well as the collections. And I'm just wondering on the collection side of things when we look at those that are
below 50% of collections um how much of that if we were to doing a doing a year-to-year comparison is typical and how much of that is a reflection of what we've been going through in public health human services
or other issues. So I'm just looking for an explanation as to those items. We have some items that are significant below on the collection side of things. >> Then I'm going to pass that over to our our uh our new director who will pass it
on to our fiscal supervisor. >> That's correct. I will pass that on to Plman for explanation. >> Good morning, Plman. >> Good morning, everyone. >> Good morning. >> Uh just for the record, my name is Plan. I'm the fiscal supervisor for Cook
County Public Health and Human Services. Um the answer is not as straightforward as because it's different for every line item. But I'll start in general and I'll elaborate a little more.
When we say that the report is as of December 31st, that's true. But we have a lot of expenditures which we report to the community health board for grants that we have incurred but we have not
received the reimbursement for. Same with the state of Minnesota. We're just now completing our state reporting to the state of Minnesota and based on those reports, we'll be receiving reimbursement. So what we're going to see in the next and as a reminder
we can continue to pay expenditures for the previous year through February of the following year and receive revenue through March. So what I've done and I've in the previous years and I
continue to do this year too is I have a projections file that I run based on revenues and expenditures from previous year for the those months that have not occurred yet. So when I'm looking at
that projection at the end of March 2026 for 2023, we are going to be looking at return to firm balance for economic assistant by a minimal amount of $7,000. um
social services will um I'm sorry use a fund balance for economic assistance of $7,000 basically breaking even um return um to fund balance by the social services department
um slight use of fund balance in both public health um department and the childcare program. All in all, we budgeted to use $566,645 of fund balance. My projections right
now that we're going to only use 163,000 of that. Wow. >> So, we will be about $400,000 better >> than we budgeted. We all know why those are. I mean we had a lot of staff
turnover which we saved some payroll but we also have continued to seek um grants to reimburse us for expenditures for our staff time too. Um those are mobile crisis response grant who covers a lot of salary for our team and we have the
community health board um grants that cover significant amount of our public health team too. Now when we go line by line by line item and I mean we could do that at some point um probably not during this meeting but you'll know
you'll notice that a lot of the um expenditures where we [clears throat] have um lower percentage I'm sorry a lot of the revenues we have lower expend uh lower um percentages because the expenditures are low too one example is the developmental
disabilities under social services team we only expended 27%. Well, we only have 23% of revenue too. So there is relation many of those there is direct relation between the revenues and the expenditures. If the expenditures are lower, the revenues are going to be
lower too. Um and again it's too early to be looking at this as a final. Um this isn't the final for 2023 uh for 2025. we have a lot of revenue to receive yet through the month of March.
So in the coming week um board meetings I will present to the board the financials for the current year and continue to update the ones for 2025 so you can be looking at
um the progress we're making on some of those line items. >> Thank you, Mr. Chair. Uh thank you Plman. So the reason for addressing this just from a fiscal standpoint is is understanding um the you know the
finances um we have as a as a county often times we get revenues that come to us later in the year. So it doesn't all happen simultaneous so that the numbers reflect the actuals until we finally get those payments. So that's understood. I
think overall understanding from your position in the in the financial uh department is that whether or not what we see is we would consider to be um good healthy uh responsible
stewardship of funds. If we have revenues that come as a result of grants that that we're applying for that reduce uh the portion of expenditure coming from public health human services that is levy dependent throughout the year
then when we come to financials and we and we do a review of them understanding what we have done to reduce that burden is beneficial. The other is the consistency in the filing of documentation to receive the funds that are available to us when we comply with
that. And so again back to the overview from your perspective when you look at it understanding that money's come in later so this does not reflect the actual um that to the extent that that you say I'm comfortable with what I see
here given our our normal practices and revenues and when they come in and so if a layman looks at this and says why are these discrepancies there is just understanding them from from the standpoint of you saying I'm comfortable
with everything here and there's nothing that necessarily needs to be changed to the extent that we have generated additional revenue through grants and things that reduces the financial burden to the taxpayer that's a good thing to note too so those are the things I think
both for commissioners but for the public as well to understand these numbers in that context is important And so your response could be that given, you know, what we've gone through in public health, health, human services,
uh we we were not able to file some things and so we lost some dollars here and there, which is something we need to correct. And if that's not a big concern, then that's a good thing to know because in some years our our filing on a timely basis for
reimbursement hasn't been done and we've had to address that. But that overall overall uh evaluation is just what I'm looking for. So the public understands that we [clears throat] understand that everything looks healthy.
I mean currently we're at 101% of our expenditures and and 92% of our revenue. So I feel comfortable where we at. And again based on my projections we will be probably $400,000 um use of fun balance less than what we
budgeted. And so I have at this time I have no concerns. >> Yeah. Thank you. I appreciate the explanation. >> Thank you, Commissioner Gamble. Any other questions? >> All right, we'll move on. Uh, sorry to keep staff here. Um, but item I I'd just
like to knock out here too with the mobile crisis contract. Frank, did you have specific questions there? >> Yes, I did. Um it's actually two related questions. The first question is uh considering the recent incident at the
co-op, the Niking incident um and evidently there were people who are aware of the potential for danger to self or others uh earlier in that day. Would this have been a if someone had made a call to the uh mobile crisis to
the crisis mental crisis hotline uh would this have been a case where the mobile response would have been deployed and if so what would that response look like? Like does somebody drive up? Does someone uh what happens? >> Okay,
>> I can give an overview for mobile crisis. So, when a person calls the mobile crisis um number, they would they could call 988. Um they could call first call for help. Um they could call our front desk and be routed to mobile
crisis through the front desk team. Um the way that the service is set up, there's an initial conversation that's a screening conversation. And if they screen in for mobile crisis response services, there's a consultation with the clinical supervisor who for us at
this point is based out of Breitwater. Um, and that conversation is the conversation that assesses whether mobile crisis is an appropriate response. Um, there are situations where they may not screen in um, and they may
have additional conversations over the phone. There's also conversations where if there is uh a danger to you know the responder or to the individual calling requesting the service that there may be uh co response with with law
enforcement. So I can't speak to exactly what this would have looked like in this specific incident but I can walk through what the steps are for utilizing mobile crisis. I'll also note that um the way we have the service set up and staffed
right now um it's it runs basically business hours. So Monday through Friday 8 to 4 and then in the evening and weekend hours it's brightwater so it's done through teleaalth um because um
staffing the service 247 is not feasible for us at this point in time. So what it would look like if a call were to come in after hours is that the person who answers the call and has that you know screening relationship would all be based within Brightwater and then it
would be um available via teleaalth to the individual calling and requesting the service. >> Okay. Thank you. >> All right. And you Commissioner Gamble. >> Yeah. Thank you Mr. Chair. Um, does mobile crisis have a a protocol that's
that's clear to those that participate? And the other are there scenarios that are are run so that they understand how what their response would be? I mean a lot of time when you're talking about crisis experiences it's anticipating and
and addressing things up front so that we have a procedure that we follow uh so that the emotion of crisis >> yeah we definitely have a strong training plan for anyone providing the
mobile crisis response service. So, anyone who is providing the service needs to be qualified as a mental health practitioner per state statute and go through all of the required trainings to be able to provide the service locally. Um,
when we do, our call volume remains low. We average around and sometimes less than one call a month. Um, which is challenging for training purposes. We're working right now with Brightwater to see if our current response staff can do
in-person shadowing in Duth with the Brightwater team just given that um despite our best efforts to create a robust training plan um the the call volume remains a challenge because there is real value in being doing in-person
response work as a component of the training. Um, and that is it's included, but it's fully dependent on the the calls coming in uh for us. So, that's something that we're actively working on right now as well. >> Thank you.
>> Thank you. Good, good questions, good conversation. Anything um further from you, Frank? >> Uh, no further questions on that. Thank you. >> Okay. Thank you. >> Thank you, Greg. >> Yeah. All right. Oh, Commissioner Gamble and Commissioner Sing. Holy cow. Okay. Go
ahead. >> Go ahead. >> Well, I said Commissioner Gamble first. Sorry. >> All right. Okay. Well, thank you, Mr. Chair. I was just going to make a motion to approve item C and I on the consent agenda. >> Thank you. >> And I was going to do the same thing. So, support. >> Excellent. We have a motion and support.
Uh, any further discussion there? Hearing or seeing none. All those in favor? >> I I >> I. >> Those opposed? Motion passes unanimously. Thank you very much.
Now we're down to item four, welcoming of new staff. >> All right. Um well, I'm very very excited to welcome we have three staff on and then we actually have Oh, Olivia popped out. We have three staff who are here who are have joined our team since
the last PHS board meeting. We have Daniel McFarland who is joining us as a family services case manager. We have Amarus Fiser who is also joining us as a family services case manager. And then we have Sarah Dregwick who is joining us
as a behavioral health services and clinical supervisor. So we're thrilled to have all three new members of our team here training in on boarding and um you know starting to work every day towards fulfilling our mission in the
community. So, welcome to all three of you and I don't know if there's anything you'd like to add or comment on. >> I just very grateful for you all joining the team. Um, much needed help. Um, and really appreciate uh your willingness to
step up. I don't know if there's anything you want to say about yourselves, background, any whatever, nothing. You don't have to, but you're welcome to. >> Well, thanks for opening up the doors and letting us in. >> [laughter]
>> appreciate it. Want you to feel welcome. >> Family services for a long time. So, uh it's good to be back in that seat again. I was doing adult mental health for some time, but uh I like working with families most of all and so I'm just
happy to be back in that seat. So, thank you. >> Yeah. Thank you. >> Yeah. Any questions for anyone? >> Anybody coming from southern states changing their mind? [laughter] Yeah. Okay. Well, we won't keep you any
longer, but it's wonderful to to meet you and to see your faces and um yeah, have a wonderful day. Stay warm and we'll see you around the building. Eh, >> sounds good. >> All right. Thank you. >> Thank you all. And >> that moves us down to item five, our
community health board presentation. So I can introduce um our guests here as they set up. So um part of our presentation and the reason for inviting our guests here today is to give orientation to the governmental
public health system and the roles that both the state, the region through our community health board membership and here at the county our our local jurisdiction play in the governmental public health system. In the coming months, we will have a presentation from
our contractor, Megan Moes, regarding our department. Um, and given um the history over the past year, as well as her area of expertise, it'll be largely focused on the human services side of our everyday service provision. So
inviting our guests here today is a opportunity to provide some additional context into our structure and responsibilities as part of the public health system. So I'm pleased to introduce we have D. Finley who is on
the phone with us joining from the metro who works for the center for public health practice along with her colleague who is here in person Janelle Lambert. Uh we also have Susan Michaels who's the director of the Carlton Cook Lake St. Louis Community Health Board which I'm
not going to get ahead and over introduce the different uh roles of the organizations but this is a joint powers board of which we are a member and Commissioner Mills also serves as uh and Frank as well they both serve as our voting members on the community health
board. So, uh, looking forward to hearing from our partners and answering any questions the board might have of what our role in governmental public health looks like. >> Thanks, Grace. Um, it's always a pleasure to be here in Cook County. I
really appreciate working with uh, Grace and it's been really exciting to see her grow over the years. I was here when she was hired and so um we've been really fortunate to see all the great work that she's done in public health here and so I look forward to working with her as the public health and human services director as well. As she said, I'm
Janelle Lambert. I'm a public health system and nurse consultant with the Minnesota Department of Health. So I support local public health infrastructure. There are six of us across the state. Five of us uh work in the different regions and one is a tribal uh system consultant. Um, my
region is Carlton Cook, Lake St. Louis, your CHB, Aken, Itaska, Cuchaching, and then I also have some of the East Central. So, I have Pine, Kabic, uh, Max and Shago, and I can't forget them as well. Um, so I we're going to talk today
about um what is public health? Kind of give you a general overview. Some of you are more versed, more well-versed. I'm know that uh Frank and Dave are more wellversed in what is public health, but this will be a little bit of an overview for that. A
history of public health in Minnesota, Minnesota's public health system, local public health in Minnesota, and your community health board. So, amongst the three of us, we're going to divvy out our presentation. >> Oh, Miss D, you got our slides? >> Yep. D, I'm going to let you move
forward as um as you hear us talk instead of mentioning to switch if that's okay. Okay. So, there are a few standard definitions of public health. Here's one of them from the Institute of Medicine. Public health is what we as a society do
collectively to assure the conditions in which people can be healthy. And then the World Health Organization describes public health as all organized measures whether public or private to prevent disease, promote health and
prolong life among the population as a whole. Um we have the three Ps prevent, promote, and uh protect and um Joanie who was the public health supervisor here previously always used to add a fourth P which I always really appreciate about Cook County
partnership. And I see a lot of that happening here. So, I always like to mention that especially when I'm up here where people are familiar with Joanie. Um, some of the public health achieves achievements that we've had in the 20th uh century. I just thought it would be
um good to highlight some of the major um steps that we've taken, accomplishments that we've had in public health, vaccinations to reduce epidemic diseases and we saw how important this was during COVID uh education or
eradication of smallox um measles. you know, we had become a uh [snorts] um country that didn't have a lot of measles and now unfortunately we're seeing what some of the shifts in um public health are doing with that. So,
some of these pieces about vaccination and um eradication of small pox are certainly big accomplishments that we had enjoyed. Improved motor vehicle safety, safe workplaces, control of infectious diseases, decline in death from cardiovascular disease,
improvements in maternal and child health, family planning, fluidation of drinking water, and reduction in the prevalence of tobacco use. Minnesota has a long history of commitment to the public's health. In 1872, the first state and local boards
of health were established to recognize the role of government to protect the health of the community. Uh public health was directed at the time mainly of control of communicable diseases and public nuisances. In 1904, the first public health
services began and were financed by the Red Cross and Christmas Seals, mainly directed at things like school nursing, communicable diseases, and infant welfare. family members took care of the sick at home and were taught how to provide the needed care.
Soon after in the 50s, state boards of health uh was firmly established and it encouraged all communities to create local boards of health. That was so successful that soon there were 2100 local health boards. So you can imagine having so many health boards
made it difficult to coordinate and communicate. So in 1977, the state board of health was replaced by the Minnesota Department of Health. >> I hadn't seen that map graphic before. >> You hadn't seen that map before? Yeah.
>> Um, so the state and local system was created by a landmark [clears throat] bill that was passed in 1976, the Community Health Services Act, or you might hear it referred to as the CHS Act. The 1976 CHS act was designed to overcome the confusion over roles and
authorities and to establish a comprehensive system and an effective public health partnership among state and local governments. Um while the law was passed, there were over 2100 local boards of health with which the state board of health was
expected to communicate and coordinate. So the local local public health act in 1987 um a statute established uh statutory responsibility with community health boards in order to clarify the accountability and roles and
responsibilities. This act uh says that community health boards must address and implement essential local public health activities. These are defined as public health activities that each resident in Minnesota should be able to expect from their local public health department. It
established public health priorities and develop a plan based on community health assessment. This must be done at least every 5 years and that assessment must seek the public input in planning and prioritization process and should
document the prog progress over time. So in Minnesota, the governmental public health system is a partnership. This partnership is essential to make sure everyone in Minnesota can be healthy regardless of their age, race, or where they live. Local and tribal public
health have deep community knowledge and relationships. We know that systems impact people and a strong public health system can have an enormous impact on motans. Partnering with local and tribal public health in this way is critical and part
of why we're here today. Um, this slide is an overview of all of the parts of the public health system. I'll speak specifically to community health boards. You'll have other opportunities to hear more about our relationship with tribes. Um and I'd like to spend some time
reviewing what we refer to as governance and authority or organization of structure of local public health which D will address a little bit more um a little bit further in this slide as or in this presentation as well. It can be a little bit confusing. Um but a little
quick overview here is that um the governance structure is held with the community health board. It's who governs the activities, who can vote on the different types of activities that are performed within the governance
structure. Um, your organizational structure is based on local control, a local decision, and that you have a health and human services board. And Dia is going to describe that a little bit more in a little bit more detail. Um, but you can see the map um that she just
had up on the far right. You can see that these are the community health boards now. So, in comparison to that one that had all the little little tiny checker boards, it's a little bit more streamlined. And these are where the community health boards are now. So, you in the arrowhead have the largest
geographic area, which should be no surprise. You really have the largest uh geographic counties. Um, but you've enjoyed a very uh robust and strong relationship with MDH and with your community health board for many years. All right. So, Minnesota has strong ties
between state and local agencies. We refer to our way of organizing as a partnership. Public health needs are met through state and local staff working together. The local role is primarily one of identifying public health needs and ensuring that there are programs to
address those needs. The state provides technical assistance, administers federal and state public health funds, and sometimes serves in a regulatory role. The public health practice section is where my job lies at the Minnesota Department of Health and um where D is
as well. Our office exists to help ensure a strong state and local public health system in Minnesota. So leadership across Minnesota Department of Health, the local public health association, and the state community health services advisory committee, or sometimes you hear that
referred to as shaq, are working toward this vision together in transforming our public health system. We know that there are gaps in the system and some places in Minnesota are not able to perform basic public health functions um and infrastructure activities to meet the
needs of counties they serve. Um, the vision at MDH is for health equity in Minnesota where all communities are thriving and all people have what they need to be healthy. And we can't do this without our partnership. Here's just a quick slide that shows um
where we are and the uh commissioner of health is at the top there. Uh Dr. Brooke Cunningham is our current commissioner of health and she has a deputy commissioner Wendy Underwood. And under each of those areas where the colors are, there are assistant commissioners that cover different
bureaus. And in the pink on the far right is the Health Operations Bureau, which is where we sit um in the public health strategy and infrastructure division, and that's where DNI are located. I know it's really small print. I just
wanted to give you an idea of where it was that we were located in that organizational structure. I bet you this chart is online. >> Yes, you can find more detail online. Yeah, right down to where my name is.
>> Um, in northeast Minnesota, I just wanted to point out we have several of us regional consultants that provide the support and technical assistance that I'd mentioned from the Minnesota Department of Health. We have a public health preparedness consultant, Kayla
Scriber. She works on emergency preparedness and response with each of the counties. Um we have disease prevention and control field epidemiologist Ellen Hill. Um we have a family home visiting and maternal child health consultant Christy Sunquist.
Um the women infant and children's program consultant in the northeast region is May Yay. The state health improvement partnerships is Anna Johnson. food pools and lodging is Jason Salom and the health equity network
coordinator is Colleen McKini. Many of us live in different places um but we are all housed out of the Duth Duth district office. Um I myself I live on the south end of Max Lake as you heard I have Max County as one of my counties.
So, I live in the region I serve, but I enjoy traveling to this area um not as frequently as I used to before COVID, but I'm really enjoying getting out and about on on days like today. Yes, even when it's really cold, I enjoy being up here in the beautiful drive I get to
make up here. All right. So, we talked a little bit about our um mission at MDH about um where you live um who you are um should not uh determine the level of public health protection that you have. So,
this framework is relatively new and we're all adapting to this a little bit different and integrating this into our uh public health system in Minnesota. This framework outlines the foundational responsibilities of the governmental public health system. It defines what
needs to be in place everywhere for Minnesota's public health system to work anywhere as we work toward a more seamless, responsive, and publicly supported public health system. This is a national framework that we have adopted in Minnesota and it
acknowledges that in addition to statewide foundation, health departments will provide additional services and may require more capacity in different areas to best serve their communities. When I talked about local control and local choice, it's really important um that at
the local level, you have the ability, you know, your communities best and that you have some flexibility and ability to determine which programs best meet those needs. So, you can see here there's these um blue squares on the bottom are the foundational capabilities. If you think
about building a house or putting down a new road, you're not going to just start putting the walls up or you're not just going to start um laying um asphalt down on an unprepared road, right? There's always a foundation. You have to build up that stren that strength in the
structure. um in whatever that structure might look a little bit different. Some people might have a stickuilt foundation, some might have poured concrete. Um but all of the components are really important that you have that firm foundation. And so we work in partnership together. Um and
transforming the system means making sure that these components are in place. And then there are some foundational areas, different buckets of work. You see those bubbles right above the um squares. And those are kind of different buckets of work. And those areas focus
more on what kinds of systems are in place within our communities to asssure that these activities are happening. And at the very top is community specific services. Um and those are the things that you might do here. Uh Grace has
done a lot of work about building in um housing equity and um child care services, things that really do impact health and social determinance of health. Those are really important things here, but they might not be in Carlton County. Um they might be
important there, but they might not be as much of an issue to that needs to be addressed. So that's some of the ways that you have addressed those needs um here in Cook County. Also, I wanted to mention too is wrapped around the whole system is equity. Uh I
talked several times about where you live, um what you look like, um [clears throat] where you work. Those kinds of things should not affect your ability to have access to healthy conditions and healthy choices in your life. Does anyone have questions for me right
now before we we're going to switch over to um D's part of the presentation >> Commissioner Gamble? >> Yeah, thank you. um a question related to the consultants that in those various
areas those individuals are a resource then for participants within the state. So if there's a question that comes up uh just to help inform direction and decisions that those consultants are available to counties. >> Yes. I those are individuals that I work
with quite a bit. >> Yeah. >> Um and and program staff within the public health team. Um, but you know, not everyone is familiar with Ellen Hill's name, but she was definitely a phone of friend during CO and got
frequent calls from me when there was a situation that I wasn't quite sure how to address. And that's really, I think, how I use them. If something comes up that isn't is a little bit out of the ordinary or we're not quite sure how to address it locally, these are the people
that I call. Uh likewise for food pool lodging, that work is regulatory and contracted to our regional MDH office. So if somebody calls in and says, you know, I stayed at this motel and I had a concern about rodents or water quality,
whatever it might be, that's the person that I'm addressing um those those calls to. So these are folks that I work with very closely on a regular basis. >> This is the and they're regional, not not statewide. These ones are just for regional. >> Yeah, those people I mentioned are just
in this region. And my position is kind of as a generalist. So sometimes things come up and we're like, oh, it doesn't really quite fit into one of those categories. And so I'll help work across MDH to find who that resource would be to provide assistance. >> I could also provide a concrete example.
So you all have heard about the resource directory website. Um, part of that idea was something that Janelle helped uh helped me um develop. So we had a issue that we had identified in collaboration with the hospital, the clinic and
Janelle told me about a model that Pine County had used and connected me to the person in a similar position to my own in Pine County to learn more about what their process had been. So, um, Janelle, you kind of get, um, the widest variety
of questions, I would say, but you also really help me navigate the state system because I'm not as familiar as she is with all of the nuance and resource available to us at the state level. Yeah, I think well I don't think I know
that it it's beneficial to understand that in the context of words that we tend to use as umbrellas over services we provide this concept of partnership and we need to see the substance where that actually is played out and that is huge given the diversity that exists
within different communities and um so seeing that that resource is available is is an assurance and it also underscores here's the practical application of what partnership means. So, I appreciate that. >> Yeah, I I that's the best part of my job
is that partnership and I meet monthly with my um I have check-in calls monthly with all of my counties and I can be more frequent than that if they need. that that's my way of staying connected and building relationships so that when a crisis does come or when there is a need to work together on something then
we have that relationship and we can work through um whatever the need or the technical assistance is and that they feel comfortable calling me. >> Yeah. >> As a followup Mr. The um a question I would ask to the extent that in our partnership it is coming
alongside and working together that is anformational and a supportive approach as opposed to a mandated and to when we have mandates that creates a sense of angst and compliance that sometimes squeezes out the sense of feeling that
we're coming alongside. It's more a regulatory um position than it is a supportive position. Not that regulation isn't important, but how how that works itself out is is huge in how we cultivate
relationships where we feel that we're coming alongside and supporting each other as opposed to a regulatory agency that creates a sense of angst for compliance and sometimes squeezes out what our objective is when it comes to the human element, how we best address
that need. So, >> yeah, absolutely. And that's really important to us. We're one of the only agencies that has the type of partnership. The state community health services advisory committee um has a representative from each community health board and they meet regularly and
form workg groups to help inform the commissioner of health about what priorities are across Minnesota. Um so that partnership is you know really vital to the work that we do too. Um so that the the areas of things that are mandated in public health are flexible
to what your needs are. So yeah, I appreciate the partnership as well. >> Yeah. Yeah. Thank you. >> And just on the note of of the mandates too, I think um there has been a history of that and uh and all counties and commissioners feel that and are aware of
it. And um just with the recent creation of DCYF, there's been a significant effort from um the state to um collaborate more with counties rather than just put upon and um and I think uh
that's spreading throughout the different state departments as well. Um Shaq is a really powerful example I think of of that direction. Um, but I know there's a lot of frustrations within Shaq too about the state says this or whatever, but but there's
there's great efforts going on there. I'd say >> I think it's a great segue if there's no more questions at this point for De's U portion. She's going to start talking about state responsibilities. >> All right. >> Yeah. I wonder, Susan, I don't know if
you were going to cover this, but this is going a little off script, but I wonder if it might be good to cover um this slide quickly just because we're talking about the partnership, so I'm Does that seem okay? >> Um,
>> sure. I can I can jump in on that. >> I just It feels like Well, we'll That's all right. We'll get to it. I'll back. >> Sorry if you couldn't hear Susan. She said that's that's fine. She'll jump in on that. We can leave it. It makes sense at the end, too. So, we're fine. I'm fine.
>> You're fine. Okay. >> Um, [laughter] so what I um I'm De Finley and I work in the same division as Janelle as we talked about. I've uh been with Minnesota Department of Health for 31 years. Um, my role is to work
with I've had a variety of roles. I used to act, I actually staffed the state CHS advisory committee for about 10 years. Um, and now what I do for the last several years, 15 or so, is I work with community health boards, um, and their
leadership on, um, the governance structures, um, their finance, uh, their implementation of 145A, the local public health statute. So I kind of serve as a
a liaison between um community health board leadership and the Minnesota Department of Health when it comes to kind of some of these higher governance level issues. And then I also help um internally manage the grants that come out to community health boards as much
as one is able to heard that group of cats that are grant management. Um so I will work a lot with Susan. I work with Grace too. But what I want to talk about is sort of that that next level of the relationship between
the state and local public health. Um as you mentioned it is a bit of a different relationship. Um there is a statute that the Minnesota Department of Health is the state um state's official health agency and it's responsible for developing and maintaining an organized
systems of programs and services to protect and maintain the health of the people of Minnesota. much of the structures, roles, responsibilities and relationships um are outlined in stage statute, but we kind of have a flexibility with this
partnership and how we make that work and how we work together. Um so this is the statute that sort of governs our work at the Minnesota Department of Health. It's very large. It's got immunization, infectious disease, how we deal with
tuberculosis, how we deal with food born illnesses, um our role in providing essential public health services as we did during COVID, those kind of things. This is the the state role. And then um the local public health act or 145A
outlines the local responsibilities. And as Janelle mentioned um that change was through the 1970 or 76 community health services act now called the local public health act. And it allowed boards um of
health, those 2100 boards of health to join together and work as community health boards to serve a larger population and geographic area. Um the local public health outline act outlines the shared public health
responsibilities of state and local government. Um the becoming a community health board has it it sets out the requirements of a community health board. And the community health board has the general
responsibility for the development and maintenance of a system of community health services under local administration within a system of state guidelines. And many of those um
many of those guidelines and standards are established through work of the state CHS advisory as you've used as you've mentioned and what this structure allows for is community involvement in
local public health local control an integrated statewide system. Originally, it it was designed to have an adequate population base for economies of scale. Um, that's where there's a there is a minimum requirement
of 30,000 people or three contiguous counties. Um, sometimes there's a some of our funding there's a multi-county incentive that outlines that gives a little bit of a a an incentive for uh working with other
counties for work. Um, and I think in your packet there's a link to the local public health act that outlines um, it's kind of a reader condensed version of the entire act. Um, and within that act at this point
there are six areas. There's a variety of requirements. One of which is to have a community health services administrator, to have a medical consultant. There's a a variety of um what has to be done the must that we call them um and but one of those is
they have to address the six areas of public health responsibility and those are um ensuring an adequate local public health infrastructure, promoting healthy communities, healthy behaviors, preventing the spread of infectious disease, protecting against
environmental health hazards, preparing for and responding to disasters, and and then assuring the quality and accessibility of health services. And these six areas of responsibility kind of explain what we do, but not
necessarily how they're done. Um, and as Janelle mentioned in the foundational areas in this area, this is sort of a what we're shifting to, but you'll see a lot of overlap between the
areas of um public health responsibility and the foundational capabilities and foundational areas. And a lot of times too, to be clear, um addressing these six areas of responsibility doesn't necessarily mean that public health does them. They have
to work with their community to figure out how they're best done for your community. Um [clears throat] what I'm going to get into now is a little bit more about the governance of public health in Minnesota. And as Janelle mentioned, this can be a little bit confusing. Um
but once it works for us um to be a community health board, they're made up differently across the state. Some are one county or city, others are multicount, some are human
services board. In statute, there's only three ways to be a community health board. The governing body of a county assumes the or a city council assumes that responsibility or appoints a board. The county joins a joint powers with
other counties or the county board assigns the responsibility to a human services board that is formed under a different statute. So, as you can see on this, um, you're a
part of a joint powers board, and that's what we call the governance, um, kind of the authority to implement public health in Minnesota. Right now, there are 53 community health
boards. We just added one um, in the beginning of in January 1 of this year. 25 of those are single county or city or city county community health boards. We have four cities that are community health boards. Minneapolis,
Bloomington, Edin, Richfield. They were grandfathered in. Um we have 17 multi-county um community health boards and 11 human service boards. And then here's where it gets a little bit more uh complex.
Practically the work is done within in a variety of ways within this governance or community health board structure and we refer to this as the organizational structure. Local public
health is organized differently across the state. Within these community health boards, public health activities are carried out by um different entities such as standalone public health departments, health and human services,
and even hospitals. Public health um must work with their community health boards to get buy in and approval for many activities. The takeaway is that Minnesota's public health system involves many layers and governing bodies, each with their own
authority, roles, and responsibilities. Um it can be a little confusing to understand community health departments, local public health departments, multi-county community health board and who does what, but um you have a
lot of strong leadership there in Cook County and at the community health board. Um so you can it's not really an issue up in your area. There's a good relationship and a good uh structure for how it works. I do have some numbers in here. You
know, Cook County itself would be one of the single county health and human services agencies within a joint powers board. The hospitals are all in the um northwest part of the state and that is where the county government contracts
with the hospital to provide public health services. A lot of this came from times when there was a lot of home care activities taking place and those were out of the hospital. Um we do have a few multi-county public health agencies.
Um and then those are you know a couple counties that have joined together within a a broader community health board. So these organizational structures you can it's just a different way to look at
uh what was already on that map and with that and that is what I have. So that's a lot. If you have any questions I'm happy to take them real quick. [clears throat] >> Any questions for D?
It doesn't doesn't look like it. Thank you. >> Yep. >> Thanks, Ste. Can you hear me now? >> Take that as a yes. >> No, she can't. >> Okay. Can you hear me? >> Yes, >> we can hear you. >> Okay. [laughter]
>> All right. Um, well, so I would like to just take a moment and bring it down to the local level. So we have all that all that at the state level and and what does that look like boots on the ground here in in Cook County. Um so this is
our org chart for the joint powers agreement for the four county CHB and you'll see at the very top is our joint powers agreement between the the four counties. Um we have nine board members.
Um three are from St. Louis County and we have two each from Carlton, Cook and Lake counties and that includes at least one commissioner from each county and and then then it could be a citizen representative as well. For um Lake or
excuse me, Cook County, we have Commissioner Mills and Frank Seio as your representatives on the community health board. Uh, and then I'm responsible to the board and I work handinand glove with Grace
and the other public health leaders in the four counties. Uh while it's my job to to take things to the board, I do very little without being in full agreement um with the public health leaders in the four counties so that we
are truly working um as a partnership in in collaboration with each other and um looking at the work as how we can support each other um as a region in addition to county specific work.
Uh from there uh the the quad county leaders, those four county public health leaders are uh have their public health staff and then their uh public health community advisory committee that they
they work with to bring information to gather information. What are the needs at the local level? what do we need to do at the board level to impact the work um at for the county and the region? Uh and then I work closely with
30 plus um contracted agencies across the region, the CHB staff and our medical consultant. Uh Dr. Kufal is from Aspirus St. Luke's and is uh again we're we're statutoily required to have a
public or excuse me a medical consultant uh but he's our he's my phone of friend uh when when things come up um and he's a attendant in every one of our board meetings as well. Um
I think that's it. Okay. So we'll jump to the next one. >> Before we do Yeah. Um, I just wanted to talk about that uh quad county public health leadership. Um, I just think there's a a lot of strength there because uh, anytime anything comes up
from one particular county, it's almost always brought to the quad county group to discuss and work through and then often times and that'll come to the CHB board. And just knowing that we have our, you know, professionals and staff
collaborating and working on that makes our job a lot easier. And um in the not too distant past uh just I think after or before just before I got on the community health board there was
quite a bit of tension um between counties and working together and that has not been the case at all. I don't think I can stress that the importance of that partnership and and how we work together. Uh when especially
with with staffing the way it is and the needs of our communities and um we're seeing more and more of a need to cross to to not look at those county lines, but to look at how do we take care of the people of our of our communities and
um whether it's a Wick family that lives on that border between St. Louis County and Lake County, they go to the ones that where they can get to the easiest >> and it might not be the same county and that's okay um because we can we can
make that work. Um maternal child health evidence-based home visiting is another um another area where we can cross county lines really efficiently to take care of families and and not worry about that. and those partnerships and that
trust amongst the leaders is is vital to making sure that that we do that smoothly and and effectively. I'll add a few more concrete examples. So, as one of the small as the smallest county in the CHP, um it's also helpful to be able
to, you know, I have a relationship with the public health supervisor in Lake County and we, you know, can connect one-on-one or in the context of the the CHB leaders meetings. And so if we're both struggling with something or wanting to brainstorm how we're
providing a service, we we can do that in the context of the CHB meetings or through those relationships. Additionally, when we have staff turnover, we can work as a region to make sure that there are not gaps in
services. So um one of um many of our nursing functions are contracted to Sat Mountain Clinic. So that uh renewal of purchase of service agreement that was in the consent agenda, that's what that is for. Um and when we had our public
health nurse position turnover, we were able to work within the CHB to make sure that as the new person was training in, if there were um needs for services that we were able to reach out to a public health nurse in St. Louiswis County, for
example, if there's a family that wants to continue participating in a service while our new staff is training in. So, it's tremendously helpful to ensuring that we minimize gaps in services for community members um to work creatively
with our counterparts in the region and that's something that the CHB really allows us to do. So, it's a huge asset locally >> when we look at those uh foundational capabilities and areas, the the boxes and then those six um musts in uh
statute 145A. Um those should be expected in every county no matter where you go. Ramsey County, Cook County, St. Louis County, if you need help that those are supposed to be there. they're going to look very different in every
county um because it's locally led. Uh and so how we make that happen in our 4count region um the the geography and what St. Louis County how St. Louis County can do it is very different than
Lake County, but we have uh a lot of back and forth and with information and resources and um just that that support and it's so important to make sure
everyone in the in the area has access. And when we have funding come into the the CHB, it's one chunk of money that needs to be divided up amongst four counties and and sometimes one of the
counties takes takes takes one for the team so that um everyone has that base funding to get the person in the place to do the job. Um, our statewide health improvement
partnership is a good example of that. We didn't go straight population. We didn't go straight geography. We didn't we we looked at what was the job that needed to get done for each county. And then we said that takes about this many hours a week. So, how much does that
cost? So, everybody got that amount. And yeah, St. Louis County did not get all the money they thought. um that they might have otherwise, but it's [clears throat] it's how how we
knew it was going to work for the region and and for each county to be successful. Um >> Commissioner Gamble, >> so long way. >> Yeah. Um I appreciate the fact that uh it's not a cookie cutter approach. So
often we see um when you look at the levels of um governance that decisions get made in the context of the authority and not necessarily with an understanding appreciation and empathy of the area that is impacted by our
decisions. So the the fact that there is a a recognition and a this partnership that allows us to define at the local level need and not just putting a cookie cutter approach on the overall umbrella
of public health is is a huge attribute. A question I had was um when it comes to the medical consultant, what is the criteria that is used in making that determination? Is it someone that is available that has the label so that we
meet the qualification or is there criteria that is used in determining who do we want to put in that position as a consultant? >> Well, they do need to be a physician and I might phone a friend on that one. Do
you have a thought? Okay. >> By statute, they have to be a physician. >> Uh D is asking if she should address that or >> Yeah. >> Yeah. That's fine. Please. >> Um, in statute right now, it is a a
physician licensed to practice medicine in Minnesota. And the role is to sort of serve as a um medical director, but also to as a link with the medical community and the
community health board. There is some um talk of um expanding that to uh a provider license to practice medicine in Minnesota because some people are struggling a little bit more with finding an a physician but right now
that is the statute and Susan say more if you want for specific to you. I I was going to say that we are lucky to have doctor you know it was not easy it's not easy to find someone willing um so
that's certainly a significant factor >> which is why there's some work being done yeah at the state level to um get maybe a >> broader >> a nurse practitioner or a physician's assistant um or someone with that level
of u certification to be able to serve in the role Yeah, I think it's present day culture. We find a lot of times finding people to fill roles is challenging. So, we're happy to have somebody that's willing to step up and
do it. But, uh, ultimately it's it's what the position is supposed to provide. And that's why criteria that identifies specifics brings u more credibility to that representation other than just the
title. And um um I mean we have many examples of people that sit in the position with title and we have people that wow this individual really is a contributor. They have lots of experience. They have knowledge. They have good personal skills and uh
communicative skills. And so we learned through experience just as the reference in the previous there was some tension in in how things operated in in a different area. You'd say, well, why is that? Why? What created that tension?
And when you see something resolved and how more effective you become when that is eliminated, a lot of those things are based upon things that you identify that becomes a criteria that is used in evaluating moving forward who sits and
how we operate because we found this works better. that I was just curious given the significance of the consultation that we rely on in that particular area. >> And it sounds like Commissioner Mills was around um when Dr. Kufal was brought
on board. >> Yeah. >> Yeah. >> Yeah. And we we kind of talked about like, well, what's who is this doctor? >> Yeah. >> And uh it happened to be Dave Lee's doctor who was the um Carlton County director.
>> Right. Oh, great. Um, so he was like, "Well, it's my personal doctor, so I vouch for him." Yeah, [laughter] that's kind of funny, but but they were struggling just to find somebody. Um, so we feel really lucky. And he's a great fit. Um, always contributes a lot and
has, um, you know, >> uh, anecdotal experience with what's happening in where he works. Uh, and just, you know, getting the experience from what's happening in St. Louis, you know, it's just, it really adds to it. there's always he's always open to topics and and open to suggestions for
topics >> and he does work with CHB staff on on some things or collaborates with um Laura Bennett on um things at at times. So, and the maternal child health work. >> Thank you. >> So, he's also available available to us
beyond uh his required meetings. >> Uh yeah. So, let's uh any other questions on >> I I had one if we do have some retired physicians in the community. If they had a license still, would they be possible candidates for something like that?
>> I believe so. Consultation >> if they have an an active license. >> So, um we are a bit unusual in the northeast that the community health board is a it's a standalone office. Um we are not embedded, you know, we don't
have office space in in a community in in uh any of the four community um excuse me, public health buildings. Uh we're officed out of Duth and we do have quite a few staff and while they are staff of the CHB
officially, they work on behalf and for all four counties. So, this is just our our one pager of of who we are in the at the CHB. And um I'll just do a quick rundown for you to give you the the lay
of the land, but I'm the director. And then Stacy Stuber is our finance uh and information specialist. She works very closely with Plowman. And um just to we work all of our funding that comes to us is on a
reimbursement basis. So you submit the invoice, we compile them with all four county invoices. We review them and then they go off to the to the state typically for reimbursement
and then it gets distributed back. So that's why there's um things don't show up right away um because we do have a a few week lag in there. Uh she's been with the CHB for a long time. um her
daughter's was wasn't born when she started and she's in high school or a senior now. So that that many years um she knows where all the bodies are buried and [laughter] um so she's a huge asset to the CHB and
then Stacy Blur and Nelson is part-time admin support and just kind of keeps the wheels on the bus. Uh Laura Bennett is our regional alcohol, tobacco and other drugs regional coordinator. Uh that is actually a um some funding that comes to
us from the Department of Human Services. So once upon a time, again, Laura's been here for a very long time as well. Um the the board was very creative and and took the first step to say, "Yeah, we can take on that contract
because no one else we needed in our region and no one else could do it." and that Laura was the first uh employee of the board besides the director and so she's been with us for a very long time
as well. Um Sporthy is our uh regional child and family well-being program manager. So she she deals all things maternal, child and family health, including our evidence-based home visiting model, which is the maternal early childhood sustained home visiting
or MESH. And you have the MESH program here in Cook County uh with a new staff that is in the process of getting all the appropriate training to uh to carry out that home visiting model here in the north here in Cook County.
Taylor Blakeman is our re uh regional um uh coordinator for the statewide health improvement partnership or the SHIP. Uh and she works very closely with your um local staff here and um we'll we'll talk
a little bit about what the ship work looks like on the ground here, but she's the kind of the media. She's she's the Janelle for ship. [laughter] Um she works between MDH and and local ship staff doing work on the ground to make
sure uh all the tees gets crossed and the eyes are dotted and the invoices are get submitted and the work plans get submitted so that the local staff can just do as much feet on the ground work as possible. Uh Stephanie Medina is our
program manager uh and planner for our infrastructure work. So, going back to those boxes, um, all of those foundational pieces and capabilities and areas, we we received some funding to to support and and build that work here in
the northeast in the four counties. Um, so she she is leading that work and she supervises Jenna Olsen and Mary Parsetune. Jenna is our public health communications coordinator. She lives here in Grand Marray.
Um, so she's um she's here in your community. She does phenomenal work uh putting all sorts of um um really great communication pieces together. The Speaking of cannabis
uh uh promotion that you might be seeing now, the posters up in stores, she designed and and rolled that all out and um is sharing that statewide. that's gotten quite a quite a few uh requests. Um she might actually be tired of
talking about it um because she's been presenting so many places across the state with that work. And then Mary Paratoon is our our public health planner. Um I believe she's been up here helping with the community health assessment and the community health
improvement plan. um she's uh just doing phenomenal work um in a planning capacity and again working across all four counties. So all of these staff while they're housed well in in a variety of places across the
four counties and employees of the CHP they do work on behalf of of all four counties. So we're really um excited to have that opportunity uh and again to have that look about how how do we cross-pollinate? How do we make sure
whatever we build in in Carlton County can be replicated or modified to to work for Cook County? And it's been it's been really um really fun fun to watch. Um and so I see my job is to just make sure
the funding is there so we can keep doing it. Uh, so those are the CHB staff and I think we wanted to talk just a moment about what this looks like feet on the ground. Um, D, did you want to start
with this one? >> I can. Um, I think this just gives some examples of how this kind of plays out. For example, um, because it's a shared responsibility.
Uh, one example that I can address is the public health lab. Um, we're we have a nationally recognized lab. Um, if you're a member of SHAK, you might have been given the opportunity to tour the lab. Um, and they work on environmental,
maternal child health, infectious disease surveillance. Um a kind of a example of the partnership is that uh one of the activities is that our lab screens um newborns at birth to see if they have
they're at risk for any rare or hidden disorders. And then local health departments follow up with those families um if they have a condition um that needs some followup and they might follow those families um or reach out to
them to um see if they need any followup or care and make sure that they are receiving the services that they need. Um, another one that I'll take on and then you can do ship is the uh food
pools and lodging. It's a shared responsibility where we the state health department employs staff to inspect restaurants. Um but in some cases we actually delegate that the commissioner of health can
delegate that authority to community health boards um and to and then those community health boards actually do those inspections. I'm assuming that's the case with St. Louis County. I actually don't know what your food pools and lodging structure is
up there. But >> here in Cook County it's delegated kind of a shared responsibility. >> Go ahead. Yeah, >> I was just saying in here in Cook County it's it's delegated. So we don't have staff at the county level or the CHB level providing that service. It's all
through MDH out of the regional office in Duth. And then um I'm going to Susan, do you want to shack? We've talked about um it's a definitely
a way to play out the partnership where each community health board has a representative often do their work through workg groupoups to establish priorities, establish guidelines, establish statewide measures. It's a way for us to
say we've done this in partnership with local public health and then Susan, I'll give it back to you. >> Okay. And then uh SHIP is the statewide health improvement partnership is statewide. It is in every county across
the state. Um it's 17.5 million that works um per year, excuse me, to support communitydriven solutions to expand opportunities for active living, healthy eating, uh and commercial free tobacco living. MDH provides technical
assistance, guidance, standards, uh for the best practices for this program. And then again, we have the regional coordinator as in Taylor to uh support your local staff doing this in Cook County. Um
this looks like um sorry uh uh one of the projects is a safe routes to school uh program for this this current year. Um there's a safe routes to school committee that
meets virtually every other month. And uh they're looking to assess current barriers to safe student travel and update the current safe routes to school plan with an outcome of at least one specific
improvement initiative such as improving signage or updating arrival or dismissal procedures. So just looking at how do we how do we make it safer for kids in your community to walk to school? Um also looking at food access
um so they want to grow uh membership in the food access council and conduct outreach with sectors that don't have representation on the food access council to increase diverse representation and then and then look at the policies, systems and environmental changes that
um will be needed to improve access to food uh in the community. And I don't know is there any other stat uh ship work that you would like to highlight? >> No, I would say we're focused on healthy eating active living with um we have two
groups active in that area and Christina Matson is coordinating those. So food access council is one of them and then the active living steering committee which includes all the safe routes work. So that's the local face of SHIP here in Cook County. >> And then [sighs and gasps] funding for
the community health board comes primarily from the state. Um and some of that is f those are federal funds that comes to us through the state. And then we do also uh grant writing for
um other other opportunities that come our way when when they're appropriate. Uh sometimes we look at small small foundation partnerships um for those unrestricted funds for some things like we don't use state and federal funds to
buy food and those types of things. So, if you're going to do community engagement, uh it's nice to be a host and to offer people a cup of coffee and that type of thing. And and so, how do we do that? And so, we we get creative with fund seeking um to make sure we can
do those kinds of things that make it um a welcoming community uh event, especially when we're asking people to give us feedback on on things. Um, so the CHB is the the legal and governing
entity for all of those funds that come through. So we're audited uh annually. We we conduct um reviews of each county. We do financial site visits annually. Um and I review all the audits for each
county as well. So that we have our we do the due diligence. All in all, I'd like to I hope that what this community health board does for the counties is keeps the money coming in and reduces the uh the burden of
reporting and those types of things so that they can just stay focused on doing the good work. um staff feet on the ground if uh so the public health nurse can focus on nursing and not all of the
recording and we need we need things documented. We know that for transparency. Uh but I hope that the CHB takes on a lot of that due diligence um to maintain fidelity of programs so that the county staff can just stay focused
on their work. I would add I think the other benefit is looking back at that that org chart and all the faces on there. There are pieces that the CHB has been able to build up so that we do not have to build that up locally. It's not always it wouldn't be
possible for us to have a full-time communication staff specific to public health or a planner specific to public health. Just we don't have that much. We don't have the funding to support it. We might not have the workload to support a full-time staff person, but if the
region can provide that assistance to us through a staff housed regionally, then we can access supports that we wouldn't otherwise have without having to build up our staffing locally. And that's hugely beneficial. So, something I've been really grateful for working with
the CHB. Well, I hope uh in listening to us today, part of the flavor that you've gotten is that it's really important to us to be in these relationships, that we don't do this work in a vacuum, and that um it's really important also to us that
local issues are addressed locally, that you have that voice and you're able to um express that opinion despite the fact that you're the smallest county in the CHB. You've done really mighty things. And um Grace talked about um my referencing another county that she was
able to access. There are many many many times where I reference Grace. [laughter] Here's some work and so I'm often connecting people from across the state and Jenna, you know. So you have representatives right here in Grand Marray um that are impacting the health
of all motans and that's I think to me the crux of that partnership is across the state not just at us at MDH or Susan at the CHB or Grace at the county it's all of us together um so that we work together to promote health and protect
individuals and um prevent illness and disease. So we we might do our our work a little bit differently than any of the other departments you've seen. you didn't see that we have these specific mandates that you might see from other programs that you have to do X Y and Z.
Um but you do need to do some work to um help the health of the community and help assure the health of the community. How you do that is a little bit different. So in public health we're working on prevention activities and that seems a little bit different too, right? Sometimes that can be a little bit harder to focus on. So I really
appreciate uh you giving us the time today to talk about that. We we love to talk public health, so we can talk forever. Um, but definitely reach out if you have questions. You can reach out to any of the three of us, but like I said, I'm oftentimes the contact point. Um,
and we'll lobby you to somebody else or volley you off to somebody else if if need be. Do you have any other questions for any the three of us before we conclude? >> No. Thank you. >> All right. Thank you. really appreciate the presentation and the overview and
the details and and the partnership. >> Thank you. >> Yeah. Thank you Janelle and Susan and D for being with us this morning. Commissioner Mills, would you like me to move into the director's report? >> Yes, please.
>> Okay. So, um, the first item in the director's report is our org chart, which is updated as of January 13th. You'll see, um, that some of the staff that positions are no longer vacant joined us this morning. So, uh, on that
supervisor line item, um, Sarah Dreswick started as the behavioral health services supervisor with us last Wednesday. Um and then under the children family services team there um Amarus Fischer and Daniel McFarland
you'll see that they those positions are are now filled with um with them taking on those roles in case management. Um at this point the position that is open and we are currently interviewing for is the public health supervisor position. So,
we have started to schedule interviews for later this week and are hoping to have some good news to share with you by the time this board meets in February. Um, and that's the only position at this point that is posted and we're currently
interviewing for some of the vacancies that you'll see on this org chart. Um we have paused on hiring until we receive and review the consultants report uh in the near future. So more to come on those positions.
Any questions on the org chart before I go into other pieces of the director's report? Well, I feel very familiar with the public health and human services board, but this is my first time. Uh, I guess I could be on the staff introductions as
well in the in the public health and human services director role. So, thank you all for um putting your faith and trust in me as I step into this position. I'm really striving for our department to do its best work in the new year as well as myself stepping into
the director role. While I've been with the department for quite some time, there are things that I'm learning and um becoming more familiar with as I step into this role. So, I appreciate um your patience and flexibility as I uh as I learn and grow into this new position in
the new year. Um notes. So, notes from the public health team specifically. The pop-up food pantry continues to operate right here in the courthouse lobby with updated signage and a survey to better understand utilization. There's a media
release planned for the near future to publicize the extension of this project. And the plan at this point is to present to the April PHS board meeting regarding the popup pantry and evaluation of both its use and the resources needed to
operate. I would consider um reaching out to other members of the food access council who are doing other food access work. Maybe that would be a good meeting to highlight some of those other community efforts as well alongside a review of the popup pantry.
The youth prevention scavenger hunt has been extended through the month of January to drive additional participation. Um outreach in both local middle schools for prevention activities has been very successful with lots of conversation and
links to local resources being provided by our youth prevention specialist Rosio Rivas. Um, both Rana and Frank will be familiar with our last advisory council meetings of a effort to expand recruitment for both our PHS advisory council and the
local mental health advisory council in the coming months. Um, and to tie back in with the community health board presentation, we received support from one of our community health board staff, the communications specialist, Jenna Olsen,
in coming up with a campaign for child and teen checkups. Um, and you'll see that campaign debuting in Northern Wilds starting this month. So gen this is a great example of how we use support from the community health board to further
both local public health and public health across the region. So um we recruited families very short notice. I was one of the families who participated along with Daniel who you met this morning and Andrea Toy um to take photos
and get quotes from local families with young children about the importance of bringing your children to their um regular checkups, their annual checkups. Um and so there are quotes and photos from local families
um that Jenna helped put together that will be debuting in Northern Wilds this this month. And those images and quotes will also be available for use by other counties in the region as well. So that's an example of how we share resources and expertise to further uh
the goal of public health. >> Some of them have also gone out on PHS social media. >> That is true. I should note that they also went out on social media. So they're going it's a it's a what is it? Multi-channel communications campaign. Um
another note. So, regarding state and federal funding, um there is a lot that you may have seen in the news about about funding for um human services programs specifically and public health as well. So, I will give uh as much of
an update as I can at this point. So, on February 9th, USDA sent Minnesota a letter that it would be in freezing funds to the state. This decision was temporarily blocked in federal court last week. The state agencies that
administer these funds within Minnesota, that's DCF for SNAP and MDH for WICK, provide counties with updates on the situation. At this point, there is no impact to services. We will continue to monitor the situation and inform both
the board and the public as the situation evolves. In addition, on January 6, Federal Health and Human Services indicated that it would freeze federal child care assistance and other social service programs in Minnesota. This decision was
temporarily blocked in federal court on January 9th. The services that would have been impacted by this freeze include the child care assistance program and the Minnesota family investment program along with the social services block grant. all continue to
operate as usual at this time. Again, we will continue to monitor the situation and inform both the board and the public as the situation evolves. >> Grace, you said February 9th was >> Oh, I meant January. I apologize. Yeah, all of these are January dates. So,
they're all updates within the first 3 weeks of 2026. >> Thank you. So, um, AMC, uh, MAXA, the local public health association, these are all state level groups that provide updates to county
leadership when situations like this could impact the services that we provide to residents. So, as I said, at this point, it's a monitor and inform as the situation evolves. Um, and that really concludes my director's report at
this time. Happy to take questions. None. [clears throat] None here. It doesn't look like Frank. Do you have anything? Oh, Gary. >> Yeah. Thank you, Mr. Chair. I I would just >> No, thanks. uh make a statement uh Grace that um uh
in in your position um coming through the organization and your lengthy service to the community that the foundational things that that we see in you that you bring to the position that uh uh we want to encourage you and u
it's a it's a situation where we celebrate the fact that you are in the position because you bring so much to the position and we've had the opportunity to observe and and to know what you're capable of. So, uh the best thing we can do for you is understand the environment in which we've asked you
to take leadership and to support you and encourage you. So, thank you. >> Well, I appreciate that. Thank you, Commissioner Gamble. [clears throat] >> All right. Well, thank you, Grace. And we'll move on for um items for board action, which is empty right now. Uh and
that moves us on to our committee reports. Probably not a whole lot going on since the first of of the year, [clears throat] but we'll we'll go down the list here. Active living steering committee. Commissioner White, >> I have nothing to I have nothing to
report on that nor on the AEOA. We've not met yet. The Arrowhead Health Alliance has not met and but there was u and nothing new to report from the Council on Aging. >> Okay. Boom. Thank you. Uh, Commissioner
Gamble, how about ARC there? >> Yeah, thank you, Mr. Chair. Uh, we met January 16th. That was our regular, uh, board meeting monthly for January, the new year. We also, that meeting was followed by a joint meeting with the advisory committee. And, um, former
longtime Cook County probation officer Steve Borude represents Cook County on this committee. Um, interesting in our discussion, uh, this probation survey report for Cook County January through December 2025 reflects a total of 76
individuals on probation. And uh, that that breaks down the result of there being on probation, 35 as a result of felony, 30 for gross misdemeanor, 11 for misdemeanor, and there was one juvenile.
um the Arrowhead Juvenile Center uh which is a portion of the ARC the juvenile center prediums for the fourth quarter 20125 they budgeted 300,000 and actual receipts came out to 538,568. Um if you look at the services provided
uh by ARC in the Arrowhead Juvenile Center uh counties using AJC in Wisconsin are Ashlin, Bayfield and St. Croy counties. In Minnesota we have Blue Earth, Douglas, Fairbolt, Henipin, Itasa, Nobles and Wright. Why that's
significant is saying that that um aside from those at our ARC in association Carlton St. Louis County, Lake and Cook. Um, and I we have uh considerable um participation with these others counties
throughout the state. 85% of the juveniles who come into corrections are functionally illiterate. In other words, 85% of those individuals coming can't read or write. That's significant. It's also a statement on our education. Um,
it's also worth noting that uh no other counties in the state of Minnesota out of the 87 counties have a corrections facility like NERK, the Northeast Regional Corrections Center. Other counties when they have offenders, they send them to serve their time at jail.
And that's the unique thing about ARC and NERK is the fact that we bring them in to try to uh reshape and educate many that get their uh GED and uh we celebrate that. When you look at the
testimonials and we've got a number in the packet in this meeting of people whose lives have been reshaped a result of being in an environment where people come alongside and genuinely care and equip them so it's not just doing time
it is it is reshaping. So very very uh very uh fortunate that we have this partnership with with NERK. [clears throat] >> Uh let's see childc care solutions subcommittee and I think that was Commissioner Stoley but now Commissioner
Gamble. Is that right? But maybe they didn't meet. >> I can add that that with NY's transition the group hasn't met. We do intend to have that group begin to meet in the new year, but um it likely won't be until February or March at this point. So, I will keep um Commissioner Gamble is
representative on the group. I will keep Commissioner Gamble updated as >> we um set a date. >> Okay. Thank you. >> We reorganized a little bit. >> Okay. >> Um community health board has not met. Had a wonderful presentation of course. uh
local uh mental health advisory council. >> Okay. I was um elected we met on the the 13th of January. I was elected to be chair again and vice chair will be Cecilia Bloomquist
and we talked about meeting every we're going to meet every other month now because there are a lot of meetings that people have to go to and we can get it done in that amount of time. So that's a change. We will meet starting in February and then April and
June. So we can do that. And then we talked a lot about people were worried about just the the stress and anxiety that people have now with some events in our community, some in the Minneapolis, and people fear things for their friends
and grandchildren and whatever. So, we talked about that and maybe trying to have some programs later or something. I don't know. Nothing definite was really suggested, but just an awareness of this
and maybe trying to help people at some point with understanding what's going on, how to help yourself, not be too anxious. I don't know. So, that that's that's all I have. >> Thank you. >> Anything else, Grace? Do you think I
forgot? >> No, I will add that um Rosio Rivas, our youth prevention specialist, is working on a January article on talking to kids about um challenging situations with some of the resources that Erica had shared and that Rosio had shared in that meeting.
>> Wonderful. Thanks. >> Uh I already um touched on the council on aging. That's next is emergency preparedness committee. Commissioner S. >> Uh we have not met yet. >> Thank you. >> Healthcare planning committee. Commissioner Sterling >> have not met. Okay.
>> I will say I did talk with Aaron Watson and Sawtooth Mountain Clinic about healthcare planning and we had discussed >> um seeing if we could incorporate what was in healthcare planning to our PHS advisory council so that providers would
be providing updates in the context of that meeting. So >> more to come on that but it may be that that group sunsets. >> Oh okay. >> Thank you. Uh, anything from Nico, Commissioner Stler? >> Next week. >> Okay. And then Northeast Minnesota
Office of Job Training Program, Commissioner Gamble. >> Oh, yeah. We're axing that. No, we're looking into that. Yeah. >> Yes. Yeah, that's a good way to >> the bylaws is and and my intent is to call director and have a conversation and and be informed on that. So, our
basis based upon assumption and the years of experience is well founded in making that decision. >> [clears throat] >> Sounds like a excellent approach. Um, Northshore Collaborative has not met. Um, PHS advisory council. Frank,
anything to you'd like to share from that? Where did they meet? >> Yes, thank you. Thank you. One of the things that we did was election of officers and I am pleased to announce that I am continuing as chairman for this 2026. I am even more pleased to
announce that we have a vice chairman. >> Yes. our new our newest member, Crystal Crystal, welcome. So, thank you very much. Um, Grace also presented the results of a an online survey that was taken of the of the membership uh with
review to our mission and uh changes that we might need to make and and uh I'll be reporting on that after further discussion with Grace next time. Um, and let's see the um also weighed in on on
the uh as Grace described the popup uh food shelf right here at the courthouse and looking forward to getting some results from the uh from the evaluation that's coming that's coming up on that. Um and I'm sorry my
brain's at a bit of a It was [clears throat] a a suggestion was passed to form a subcommittee for recruitment and at Grace's suggestion that would be a joint subcommittee with the uh local mental
health advisory council and I'm looking forward to uh getting together with them to uh to establish a joint plan for recruitment for for both um for both advisory councils. Thank you. >> Thank you. >> Any questions?
>> I don't see any. Thank you very much. Um, next one is the Food Access Council hasn't met since I mean we have met since the last PHS meeting, but I gave a little brief update of our past regular meeting. There's a wonderful article on
WTIP's website um about um the SuperShelf model and and just the going on there that I'd encourage everyone to check out if you haven't already. Um last thing is for the good of the order. Anything there?
Thank you for your patience and help um this morning and um we are adjourned. >> Thank you. [clears throat] 10 minutes later. Should I stay on or am I going to transfer to a different number?
>> Uh, you're on the phone, right? >> Yeah, >> I think that'd be great. real soon. But >> we just had