about about a vaccination I think I want to say vaccination clinic and it was Winona County and somebody else can you highlight tell me what's going on there in our community what that's all about
please >> I am not sure exactly which clinic you saw online but certainly we are promoting vaccination clinics across the community >> well what so what's our role I mean it it's a >> it was the radio. So again, I didn't see
anything ever in print. >> So we are supporting the school-based health clinics in school. >> Yep. In the schools to do vaccinations. Um the Winona Health is actually providing the vaccinations and our staff um and some nursing student volunteers are um assisting with that.
>> Okay. So is that do we have dollars invested or is that N? It's >> just staff staff time. >> Staff dollars. Okay. And is it I hate to say vaccinations have become very political just with even within I think the last day or so because now the
>> yeah the the CDC is coming out with something different than the public health and everything. So um and then with another item down the line our role is education or what what is one public health which
uh does include immunization. Yes. Okay. But it but is it providing education in regards to immunization or >> So our public health office does provide education and promotion of immunization. We also provide vaccinations to certain
populations that uh we have funding to support uh largely that would be uh children and low-income adults. >> Okay. >> That are uninsured or underinsured. Okay. >> And how do those people learn of these opportunities?
those individuals that can receive immunization through us um through public promotion or uh different community resources. >> Okay. So, the ad on the radio was like Winona Health paying for that. >> I don't know. I I don't know the ad specifically, so I can't speak to that,
>> but we don't have any budget any line item for that type of thing in our budget, do we? Well, we've got edge >> for immunization. Yes, we have dollars to support immunization. >> Okay. I guess >> you're talking about paying for ads. >> Well, you know, you're on the radio, it cost you something. And then was not our ad,
>> right? >> And clear what you're asking? >> Well, I think maybe we need some followup to see. I'm unclear what our role in it is. >> And again, with all these changes and with the politics of immunization and everything, I want us hopefully to be a
source of education using, you know, facts and science and things like that versus >> So, we take our lead from the Minnesota Department of Health regarding our responsibilities as a county. um and that continues to be to promote and educate on the importance of um vaccination and immunization.
>> Well, we will be having a meeting there in early October. So, I think this might be a topic of discussion. I'm not sure that that'll be interesting because and it's interesting where the the you know the big health organizations are going with this. Okay. Um then moving on four
point if anybody have anything else? Uh 4.1 approved professional services agreement with Winona Health for Dr. Kelly Osterman to provide medical consultant services. >> Um se there is a contract agreement um that speaks to the role of medical
consultant that we are required as a community health board to have. Um Dr. Odin has historically been our medical consultant. Um and we have entered into a contract with Dr. Osterman and Winona Health to provide that service. Um and at our next community health board meeting, you'll have a resolution to approve co-medical director roles for
Dr. Dean and Dr. Osterman. Um largely we've needed some additional support um regarding our pediatric um care and our vaccination protocols that we follow. Um and Dr. Oman is a pediatrician. She's been practicing at Winona Health for I think about 10 years.
>> Commissioner Vley, >> um two things. The small thing is I don't want to turn this into a a big concern, but um it's listed as consent business. Should in the future, should we bump if we're going to discuss it, should we bump it to general business? Otherwise, we should I mean I don't we
can talk about it for future reference. We this is how we usually do it. >> Yeah. >> But if it's if it's if we're going to discuss it, then we should bump it to general business. >> Well, it's confusing because we do something here and then it goes to the main meeting. So, yeah. >> Do we discuss it here or do we >> The second thing is I'll make a motion
and approve item 4.1. >> I'll second that. >> Okay. We have a motion by Commissioner Vagely, second by Commissioner Meyer to approve 4.1 the approval. Um the question I do have is that we need this. Yes, it's part of the statutory requirements and everything.
Did we have any other pediatricians interested in doing this? >> No, we reached out to both Gunderson and Winona Health um to locate people that may be interested. We've had s several meetings over the last year um to locate um somebody that would have the skill
set to do that. And Dr. Ostman is interested in doing so and she has actually started attending our health and human services advisory committee as well um and has been a nice compliment to that um committee as well. So she's invested in um our work >> been for the last four meetings.
>> Okay. All right. Well, you have to realize that I think we all have constituents that have some concerns. So just duly noted. So all those in favor say I. >> I. >> I. Nay. Okay. Approved. Uh 4.2 two. Uh the approve of the Minnesota Department
of Health Board grant project agreement for state health improvement partnership. >> I'll move item 4.2. >> I'll second that. >> Okay, we have a motion by commissioner vaguely, second by commissioner meer to approve the grant agreement for the state health improvement partnership. Um
I did have just one question though. I see we have to match 10%. We have funds in all those other versus local levy. We're we're can cover it with all those other pots of money versus local levy. Yes, we won't be using levby funds for that match. >> Okay. All right. Thank you. All right.
Any other discussion? All those in favor say I. >> Oppos? Nay. Okay. Approved. >> Gee, we got five minutes here. Um, general business, anything healthwise, people,
allergies, cold and flu season. Uh, hey, how about this new Emily? You're not a a doctor, doctor, but it's an ad. People can get people can get u they're advertising it, you know, a flu mist that you can just get it home and give
it to yourself. That's kind of, you know, some little kids saying, "Oh, your mom's going to give you a shot." No, it's a mist I put up my nose. Are you familiar with that? Is that what we're doing now? Instead of sticking you in the arm, you can do a nose mist. >> There are certain populations that a flu
mist is uh considered and a a recommended intervention for vaccination. Um it is in typically um specific populations and it generally is not as uh widely utilized or recommended as the injection >> well somebody's promoting it some it's
on TV there's money to be made somewhere >> you've seen it too yeah they're promoting it and I guess you know a lot of people that to get in to see a doctor of course now you can go to your CVS's and your hes and get a shot too but the whole concept of getting into see a
doctor to do this is almost you know um getting to be very difficult. So I guess I would encourage if people find that to be acceptable that new technology. All right. Any other general business? >> I find it interesting. there's something
long before the political aspect that I know is going to be coming about of new information, but uh I've said this for years that I've questioned the ability for the human body to take so many artificial things put into it and knowing people that have been on the
other side, not come out the same, but parents that have said, "Hey, I gave my kid this shot and he's never been the same since." And you know, witnessed that firsthand. And so regardless of that, I think information is good. And um so it's interesting to
see that some of the things that I've felt all along long before this was a political conversation and studying human health and animal nutrition and everything else that it it's interesting to see some of the facts coming out. And I I hope that it can bring light to
whatever sense might be out there. And there's, you know, oftentimes two sides to every story. and maybe we've let the the pharmaceutical companies run a little too hard and maybe we're seeing a little bit of a check in place. So, it'll be interesting.
>> Yep. It's it's every night there's a new drug being advertised and where they come up with these names and and uh things and then of course we're always um it's always interesting to see how fast they can read the side effects at the end of the year. >> Yeah. Well, and I just, you know, my
wife's been in hospice her whole life and she tells me stories. >> She works in it. She's not there. >> She's been inospice. Yeah. She couldn't be in hospice her whole life. It's six months left to live or not, but or to live. But,
>> you know, it's just amazing to see the amount of things pushed down people's mouths that she talks about. >> Oh, yeah. And you can't tell me that at some point the human body just can't respond. And so I'm just glad that at least in
some sense there's some checks and balances being looked at. >> Okay. >> Motion to adjurnn. >> All right. Second. We have a motion by Commissioner Olsen, second by Commissioner Meyer to adjourn. Any further discussion? All those in favor say I. Oppos? Nay.
>> Good conversation. All right. >> Good evening. >> Evening. >> Another beautiful day in Winona County. Uh didn't be careful. Uh didn't start out so good the visibility and I think tomorrow morning the visibility is going
to be also very limiting. So please be careful and be cognizant of how far you can see. Um be safe. All right. Uh we start our meeting with um public comment. Um is there anyone seeing our room is very sparsely attended tonight.
Uh is there anybody online wishing to make a public comment? >> The first time in a while. >> Yeah. >> Not seeing anything. >> And again I'll ask is there anyone online wishing to >> comment? And for the third and last time, is
there anyone wishing to comment to the Winona County Board? Um, seeing no action, we'll move on to uh item five, approval of the county board minutes. 5.1 is the county board of September
9th, 2025 and 5.2 the closed session of September 9th, 2025. >> Move to approve 5.1 and vice. Okay, we have a motion by Commissioner Vegley, second by Commissioner Olsen to approve the meeting minutes for September 9th
board meeting and close session. Any discussion? All those in favor say I. I. >> Post nay. Okay. Approved. Um item six, acknowledge receipt of the approved committee meeting minutes from the Whitewater Joint Powers Board. >> I just had one thing. It does say
February 20th. Is that correct? >> Um can affirm. I'm most certain. Yes, >> it is from clear back then. Okay. >> Because you meet what? Quarterly. >> Yeah. >> Yeah. >> So I I assumed it would have been the following one, but okay. So moved. >> Second. >> We have a motion by Commissioner Olsson,
second by Commissioner Elling to acknowledge the receipt of the Whitewater joint powers board meeting. Any discussion? All those in favor say I. >> Oppos? Nay. Okay. Approved. Um item seven, uh consent, comments, and approval of the agenda. Uh Attorney
Sonoman. >> Nothing. Thank you, >> Commissioner Begley. >> Two quick comments, please. >> Okay, comments. Commissioner Elling, >> comments at the end, please. >> Okay. Commissioner Olsen, >> nothing for me. >> Hey, Commissioner Meyer.
>> No. Thank you, Madam Chair. >> Okay. Um, Administrator Holty. >> Nothing, Madam Chair. >> Okay. Um I depending I may have a comment but I'll I'll hold take a placeholder and then I would um like to
poll 82 for a separate vote. Um the other items were covered um in our public health um portion of the meeting that I had questions about. So we've covered those. So just pull 8.12 to make that separate
vote and we can make that 9.0 O if please. >> I would move to approve the agenda as it was modified. >> Yes. >> A motion by Commissioner Meyer, second by Commissioner Eline to approve the agenda as modified. Any discussion? All
those in favor say I. >> Nay. Okay. Approved. Uh if you'd read the consent items, Miss Holy, please. >> 8.1 Approve renewal of veteran services office operational enhancement grant
program agreement. 8.2 approve amended prosecutor by Carpel BCA juvenile interface contract. 8.3 approve crime victim services 2026 grant agreement and resolution. 8.4 Approve amended contract
with family and children center for treatment court testing. 8.5 approve LG220 gambling application for exempt permit Bluff Country chapter of Minnesota Deer Hunters Association. 8.6 6 approved professional services agreement with
Winona Health for Dr. Kelly Austrian to provide medical consultant services. 8.7 approved Minnesota Department of Health Community Health Board grant project agreement for state health improvement partnership. 8.8 approve purchase of service
agreement with Timeout Behavior Coaching LLC. 8.9 Approve renewal of services agreement with Minnesota Family Investment Program for 2026 2027. 8.10 award bid for dump box and snowplow
package to universal truck equipment incorporated. 8.11 approved Northrisk Partners as agent for Winona County Health Insurance. 8.12 was pulled. 8.13 approved 2026 citizen advisory committee's process and timeline. and
8.14 confirm payment of dispersement. >> I move to approve the consent business as it was read. >> Second. >> We have a motion by Commissioner Meyer, seconded by Commissioner Olsen to approve the consent business as read. Okay. Any discussion.
Um just one point on the so people are aware, our citizen advisory committees are we have openings. Uh it was on part of the board packet the the grid that we have is that um we will be posting then all those openings on our website
correct so people know and if you serve on any of these committees sometimes you know to remind people and then also to uh some need some recruitment to to fill those slots. Missy, >> if I may, Mission, so everyone who is serving, who is eligible for another
term, um, or if there's a reminder that needs to be done for them to reapply, etc., they will all be contacted. Yes. And we will follow up if we do don't do not receive affirmation, >> right? >> So, they will be contacted. >> Good. Good. Because we have had some
slip ups in the past. Yes. >> And we do our best. Absolutely. All right. Uh so all those in favor of the consent business as read say I >> I post nay. >> Approved. Um so then uh item 9.0 which
was 8.12. Uh just need a separate vote on that. That's approving the department head association labor agreement. And I am optimistic that at some point in time I will have a pay for performance
highlighted in there but not yet. I'll move to approve uh what had formerly been 8.12 which is now 9.0. >> I'll second that. >> Okay. We have a motion by Commissioner Vaguely, second by Commissioner Meyer to approve the Department head association labor agreement 2025 2027. Any
discussion? >> I like your pay for performance. I keep pushing for them. >> Okay. All right. So, all those in favor say I. >> I post nay. Nay. Okay. 32. All right. Thank you. All right. Moving into um 9.1. our uh strategic plan update and
that starts on page 330 >> and who's going to lead that discussion? Miss Holty. >> Yeah. >> Okay. >> Good evening, commissioners. Uh so in the packet you'll see the strategic plan
uh that was approved in April of 2025. uh we've been working with the leadership team to implement actions that align with the strategic plan. So first of all I want to thank Bob Bamnik and Nancy Johnson for the introduction
on the strategic plan. They wrote a very nice uh outline saying all the reasons of why Winona County is a great place to live and work. Um so I do want to give uh kudos to them. It was very nicely written. Um so as part of the street
plan uh just a note that where there are the double asterisks uh within the document are the updates. Um so on the very first page where it says under the um kind of descriptions if you will
under private and public schools. Um it says have worked with and continue to work with rural schools to develop and promote safety plans and training. And then it says ongoing BK. So that's Ben Klinger. So we just wanted people to kind of make
notation of who they were putting in the notations for you. Um hopefully you've all had an opportunity to look at the document. Um are there questions or comments on the actions that we're doing or
again the intent is really just to bring it forward and show that we are taking action to align. Thank you for making it easy to to find the new additions both in a red font and with the asterisk. That made it a lot easier. Thank you for that.
>> I'm questioning um I don't know if it's old technology. Facebook I I don't know if there's something to replace it, but it seems like Facebook has changed a lot and I don't personally use it. U my husband follows some things and it and he comments too it's changed
considerably. So, I don't know with technology changing if there's going to be a better way to let our citizens know what's going on. I mean, I think we just need to be cognizant of that. If there is going to be a better way, Facebook seems to be uh his comments is they're all trying to sell you something and
there's a lot of scamming on that. So, are the question I guess would are people seeing it as a reliable source of information? I will say this, when there is a big storm and maybe there's flooding in town or trees down, a lot of
people do go look on Facebook and you can find that kind of stuff. Our emergency management or the city police um and those situations I I >> even this past summer I have used it several times and feel like in that case I really do see sort of see the point.
>> Okay. All right. That's good to know. people are putting their information across multiple platforms. >> Yeah. And we'll just have to be cognizant of maybe there's something better to use at some point in time or >> it's usually multiple platforms. >> Yeah. Yeah.
>> We have ours on three, four. I think I look at one because I where I look at it. >> Well, and a concern is that it's reliable information. Facebook is used for a lot of scams and everything now. So, I mean, no, dear, you can't buy Hoka shoes for $5. I mean, they're not going
to ship them to you. I mean, and there's a lot of selling of material, you know, things. So, again, just we're cognizant of it. Um, yeah, there's a lot in here and I do appreciate I I understand I will probably have to request a color copier though because I can't get the
colors on my printer. But, uh, there's a lot of stuff here. And this you just what's the intent to review periodically or to keep updating it or each department's doing their area of expertise?
>> Yes, we discuss this at every month's uh department head meeting >> and I asked them to take it back to their leadership team. Uh and again, you know, what actions are we taking to align in this direction? Um, and so yeah, every month I'm asking them to
update the documents so that we can keep the board informed of where we're at. >> And our hope is then next year we'll come back and you'll revisit the strategic plan. And if you have a different direction, a different area that you want us to focus, then we'll
modify the strategic plan and we'll go back and focus our energies on that. >> So no action required. >> Nope. It's purelyformational. >> Okay. And then is there um again for the public to see this then is there is there a site is there something on our
website that they can just go to find this versus you know it was in our board >> put it on the website. >> Yeah. You know it was in our board packet but somebody isn't going to know to look at the September 23rd board packet to find >> I can have Heidi put it there. >> Yeah. I I mean I don't know if anybody really wants to look at it but even for
myself it would be easier be versus trying to sort through a long list of county board packets to find it. Simple enough. We can do that. >> Okay. I think it makes sense. Do people agree? >> Make it more accessible. You >> can always take it down if you change your mind. >> Yeah. Yeah. Okay. All right. Thank you. >> Yep.
>> All right. Uh then moving into 9.2. Discuss approved proposed insurance plans. Page 239. >> Good evening, commissioners. >> Good evening. >> Todd Sler, director of human resources. um recommending before you is having two
additional um health insurance plans. We currently have a comprehensive medical plan that's 300600 deductible, 300 individual, 600 family. Um recommending that we also add another one to that uh as an option which is a,000 single
30,000 family. Um the cost for that is a 11% increase versus 29. Uh, but we still have to keep the first CMM because it's in our collective bargaining agreements. The second um, health insurance plan that I recommend we add is to our high
deductible. Currently, we have a 3,000, $5,000 deductible, adding the 5,000,10,000, 5,000 single, 10,000 family to that. Um, again, it's it's it's a savings for our employees as well as us. um we can't force the employees
to move but through education um and doing the comparables you know through that process helply um having some of the team members our employees move to those other plans. So >> yes commissioner thanks um Mr. Sadler.
Uh, so will these I support this. Um, if these plans are adopted, will they be available for the open enrollment that begins at the end of this or later this year? >> Yes. >> And so then if we are able to realize savings from the newer higher deductible
plans, we would realize those savings in 26. >> Correct. And we will kind of have an idea once the open enrollment period ends how that's going. >> Yep. Correct. >> Okay. Great. >> And open enrollment's coming up November. It's my first one here. So,
November. So, >> so with Anybody else have questions? Have we played with um the Have we got any bargaining leverage with like co-pays or deductibles? >> Um >> as far as the You mean the deductibles?
Um >> and and the portion of co-pays that people are having to pay and in in network out of network um are there any leverage chips there that we can use >> when when our broker sent it out. I mean for looking at a cost savings for us
that's that's what they came back with. Now the two plans that we have the 300600 the CMM and the high deductible plan we have to keep those as defined because it is in our collective bargaining agreements. So what what's a co-pay on the highly high deductible? Does it vary?
>> It varies. I mean once they hit their their deductible I mean the thousand uh for single I mean then it's then I think it's 8020 if I remember correctly. >> There's no way to change that or if we negotiate something different to reduce the price. So then with this high
deductible health plan the the county does contribute. >> Are we maintaining that same level of contribution? we are I mean the percentage yes um of what we pay but for each of these
plans it depends on what that plan cost is what our premium would be I mean what we pay as an employer >> but but we're make the county is making a flat uh >> for the HSA >> oh the health savings I'm sorry the health savings account yes we're we're continuing that we didn't change that
>> okay that's staying the same yeah and remind me that's >> two 22800 Okay. 2,000 for individual and 20 >> 2800 for family >> from individuals. Um and then the I know the big thing is you know in network out
of network. Um are these >> this is with No, it's not Blue Shield. It's um >> it is Blue Cross Blue Shield. >> It is Blue Cross Blue Shield and anybody any doctor in their right mind should have some association with them, right? Because they're the big player in the market. I think that I've not heard
anybody being denied for even out of state. Okay. So, >> okay. Um yeah, Commissioner Vegley. >> Um just to get it on the table for official and then people can still jump in is it's hard for me to make a motion
to do this is such a large increase, but I will make a motion to approve um the proposal in front of us. 29% after last year's 30%. This is just crazy. But unfortunately, you have the staff has
done all that work and there are there aren't many other options. So, I'll make a motion to approve the recommendations that we have in front of us. >> I'll second that. >> Okay. We have a motion by Commissioner Vaguely, seconded by Commissioner Meyer >> to accept the proposed and it's uh with
Blue Cross Blue Shield and it's um well the plans that are outlined on page I I forget when we discussed this >> 240 I'm just looking at the single family and it's 1387
and I'm assuming the 300900 and the 700400 are transposed or the $1,600 is actually the $300 deductible. Is that correct? Uh, what are you >> following me here?
>> Page 240. >> Page 240. And then I'm also trying to figure out how a $1,000 deductible is technically more money than a $700 deductible. >> Not sure. following the question. So for
like for the comprehensive medical plan, our cost would be 1303 a month. The employees cost would be $229.99 per month. >> I'm on page 240. >> Yeah. I'm not sure those Yeah. Yeah. >> You see what I'm saying?
>> You'll see it when you see it on here. >> I don't see those numbers. Oh, right. >> Where did that We have a 306. >> Yeah. I mean, so the if the questions, are the numbers
accurate? Well, if a 300 a 300 isn't going to be cheaper than a 700. So, it tells me the first columns are transposed that the 700400 should be the $1,200 premium and the $300, $900 deductible should be
the $1,600 premium. Correct. >> 2025 and 2026. >> Yeah. But is that >> Yeah. So, that's same. >> I guess I'm just trying to figure out, >> right? How is 300 900 the same as a 7
and the 1400? >> That that should be 300900 I believe. I mean that what this is supposed to show is what the 29% increase is going to be for that plan. It's the 300 plan is that that this should be showing
>> based off the 300 plan. The 300 plan is the608 going to6008. It was 1246 going to 168. We don't know what the 700400 is not listed. >> And then the same the thousand plan is going to go to 1386 but we don't know
the 700400 would be >> you know disregard that. >> And then and then >> higher than higher than this but in between that >> right right is what I'm reading. >> That is correct. And then what you'll see on the high deductible it says 3,400 6800. That's because the IRS they
regulate that and every year they generally come up with the different you know >> so this number the 1608 is based on the 300 900 not the 700400 >> so the 700400 but falls somewhere between the th00and and that number so
it could be like $1,500 arbitrarily correct >> correct sorry about that I didn't catch that when it was put together so >> I'm just trying to make sure I understood it >> y good question >> what the hope is that people when they see the between the gray column and the 26 column that that might
>> encourage them to move to that plan. >> Yeah. Because a lot of employers, if you're looking at the comprehensive medical plan, they have a,0003,000. $300 for single is kind of an I mean, it's just not really >> it's low. It's not out there in the market. So,
>> private sector doesn't do that. What um you know, one of the things is that um it's easy to just sign up for these programs, but do we do do we offer >> employees um to compare what maybe the
spouse's plan is? You know, this stuff is very for the most people it's very confusing. They'll just sign up for whatever and deal with it. But do we do do we help them do any analysis that sometimes it's better for the spouse to go on their company versus this plan?
And kids and they they jock around. My kids are always doing this. It depends on what the pri what company they're working for and what plan is better. Is my husband's plan better this year or is my you know daughter's is my plan better this year? And they're constantly analyzing that. And I think we need to
provide if people want this, we should be a providing some type of analysis um to you know compare because it's not all apples to apples because of the deductibles and the exclusions and the things that aren't covered and covered and in network out of network. It's it's a Yeah, it is.
>> Yeah. So I would really encourage us to offer our employees some type of help in navigating you know this stuff if if they want you know if they want it. >> I'm going to warn you, Commissioner War. Sorry. It's the >> You don't understand how good this insurance is compared to everybody else.
You have nothing to gain here. >> Well, I I guess all my children my children work in private private sector and they do. They they shop. I mean, between in the private sector, >> one thing we're going to do is is educate. I mean because you know with North Risesk our agent on record will be
coming in and and helping with open enrollment educating our our members and again negotiating with the insurance company for us. >> Yeah I mean they >> we had brought up some topics in this um you know not sure what we're at liberty to discuss but some of the leverage
points we talked about some of the instant you know and bringing that out and leverage on the bottom side up rather than the top side down were we able to gain any traction? We will. I mean, I had to get a record, an agent on record and that was done tonight. So,
I'm gonna push for leverage. Absolutely. Absolutely. >> Um, one thing that we just did is through the wellness, we did the biometrics. Yep. >> And I know we can't know individuals and we shouldn't know individual, but can we get a report? I, you know, they said, well, our rates went up because we had
three uh I think the term was three cancer cases that drove things up. I would like to know through the just through that biometrics because I know we had a lot a lot of people take it. I don't think everybody did, but what's what's the general health of our population? Um I think Hi should be able to provide us something. Um and just for
clarity, you know, are we healthy or not healthy? >> I tell you a quick funny story that just happened to a buddy of mine talk about general health. Yeah. He had to go in for a CAT scan and they talked about having lesions on his brain because he's having issues and he has heart issues. This happened about two weeks ago. they
said talked about these lesions. So he got done, he got out of the scan and they had the screen up and there was two big white spots on the brain and he panicked and he goes, "Oh my gosh, I got brain tumors." And the nurse looked up. She goes, "Oh my gosh, those are not
yours. Those are not yours. They're the last guy." >> Whoa. >> He had a like Yeah. >> About had a panic attack. >> Oh, I can see that. >> And he was in there for his heart. >> Yeah. So, >> hey, >> but I think if we can just get something
through those just to get a sense of, you know, we have this wellness, we're trying to make people more aware, we're covering the insurance, you know, what can we do, how can we improve it. >> Yeah. And part of that education with like North Risk and getting the the most current information out there. A lot of times it's your heart conditions, your
diabetes, and a lot of those medications you see advertised, they're being advertised for a reason because they're pretty costly. that anyway. >> Yep. Okay. All right. Um so we have a motion to accept the proposed plan um as presented. Any further discussion?
>> Okay. >> Uh all those in favor say I. >> I post nay. >> Regretfully I just it's just unsustainable. >> And as a country we spend the most on our medical and >> single pair single pair. >> Pardon me.
>> Single pair curl. >> Okay. Um 9.3 discuss the carvy >> kavira cavira cavira concept service membership. >> Okay Todd you get this one too.
>> All right so thank you for the time again. Um coming before as a recommendation uh for the board to uh consider Cava. Um it is a membership service. Um there is a cost associated with that about 60,000.
Um it is tellaalth. Um and in those services they cover everything from you know they'll do the diagnosis certainly not major diagnosis but you know like your stress and your your illnesses that are occurring
and um a lot of times that'll be over the phone. Uh it could be virtual. Um and then prescribe medications and there's up to 300 medications that they prescribe. You know, my assumptions are it's like augment and some of the the anti those kind of medications. Um the
example I give is like strep that used to run rapid through my families when my kids were little and they would come out, you know, and do a cultural swab at a person's house or county building um wherever they're comfortable versus
going into uh the medical practitioner's office. And I do, you know, I think that is it's it's something that's coming um especially in our rural and when I say rural it's not but you know Demain metro where I came from is considered rural
and you know a lot of it is um where we're losing less more and more practitioners and looking at ways to you know to work through that and this is one way that some employers have found >> I'm Sorry, Commissioner.
>> Tic tac toe, please. >> My comment item. >> You know, it's, you know, these add-on deals, I get it, but the the one thing that bothers me is I see, and again, I would still take it with a grain of salt even if it was presented, but there's really no
information as to the potential to reduce a cost. there's no no metric put into place to say hey we see an average reduction of XYZ by XYZ right that's what scares me a little bit I also
tend to say hey if something's provided by somebody even if you pulled a group of people and it's free it it doesn't matter it could even be an ugly t-shirt and x amount of people are going to take an ugly t-shirt just because it's free it's the free food concept why do people
eat free food it's free they feel obligated or just hey it's free I got better take advantage. So I just wonder if I to me to prove this I would want to see evidence that there's some sort of savings and I question when push comes
to Chev that this is going to be the first phone call get picked up and I also question even if we pulled employees who would use something like this would it actually come to fruition. So I would challenge this group to provide us information and statistics as
to what they've seen at deduction and these incidents in the past to justify the third of a levy point it's going to take to pay for it. That's just my that's my take. >> I I tend to agree I'm not sold on the
concept. The concept it's a concept. Um, one of the things I would as a piece of information, so on our workman's comp coverage, MCIT offers something similar to this and I would like to see >> a lot of health care programs do too.
>> Yeah. It is what is our usage of that? Have our employees used that as a tool to reduce workman's count things. It's a simple thing like if you you fall, you know, should you go to the doctor or should you put ice and rest and and things like that. So that I think to me
that would tell me if my employees are in tune to using teleaalth type of concepts. I don't know >> healthcare providers have that you know nurse hotline and things that I you know and if we could see a statistic from >> uh I'm going to say I don't know again I
don't know if they keep these metrics but if if >> our former healthcare partner said hey we received x amount of phone calls yeah people are very active and do this. We could use that as a potential gauge for something like this to say, hey, the likelihood of this actually happening.
Great. And then also there's even if that did, there's still no data as to, hey, this is going to reduce your because if they're basing it on the large case scenarios, right, which we won't provide specifics,
I that's why I challenge back to the underside. Well, if you're only going to base me here, what about down here? This doesn't actually improve that. I I think we want maybe a little more data to before we start spending this money. Commissioner Begley, >> um during the last discussion about
this, the idea is and I'm I also have a lot to learn about this. This is new to me. I want to hear what the employees have their experience with it. I'm okay approving the concept and one year later to Commissioner Elsing's point you would have data to compare where were there
savings and how much savings and were there improved services because it right now it's just a it's just a glorified sales pitch. Yeah, there aren't any numbers to base a decision off of that based on what the dis at first when we began talking about it last time it sound like a gimmick to me but the more
you talked the more you convinced me um during the last discussion of this. I'll make a motion to maybe it won't pass which is fine. I'll make a motion to approve the Cavier membership services. >> Commissioner Meer, do you have any data to share from people who subscribe?
>> No, I mean this is they've had um teleaalth like doctors on demand and some other not sure what it was called up here. Um but this is new where doctors on demand even they charge 35 bucks or 30 bucks for the employee to do
it. Um this is supposed to be free. So I can ask I did not ask for any data on that. And also I you know the idea of the survey of employees if they would use it. So but >> I will go ahead and second commissioner Begley's motion.
>> Madam Madam Chair, can I interject here at this point? I I reviewed this both as county attorney but also as a as an employee of the county and I was struck by um well first of all it's based in Yisetta. >> Yeah. >> Um and um it seems to me to be kind of
you know they're trying to make money off of a concept which I'm not sure they're going to make money. Um and I I was troubled by the description that it would be not voluntary. So >> voluntary isn't it? It it it troubled me that it might, you know, require
employees to use this without any choice. So I >> as a first line >> as a first line. >> Yeah. Well, I'm not sure. It's it's so vague in there. >> Where did you see that? >> Um it's on the description there >> because the reason was when was
described to us last time optional. >> It's it's optional. I mean >> well the it >> she does say no on page 43. operate and employer funded nonvoluntary memberships. >> When you random numbers and talk about
only like 21 people on ahead, >> yes, Minister, >> am I interpreting nonvoluntary membership service? In other words, meaning that no individual employee can opt out. Basically, it's you and you have to enroll all of your employees.
Whether they choose to use the service or not is up to them. >> But you're paying >> But you're paying for them. whether they do or don't. >> And it makes it very difficult for me to support something that I have virtually no evidence of use, >> previous use or potential savings.
>> I would I would like to know if any other counties have used these people. Um you're right, K uh attorney Sonamon, it it's um >> I would want to see a picture >> metro base, too. I mean, where you've got a large group and and um >> yeah, the home visits are kind of you
couldn't even find out if oneonone was covered. Yeah. >> Otherw otherwise it's tel. >> Yeah, they need a very large pop. They companies like this need a very large pool and then they get a small portion of them and they can you know like you said hopefully make money on it. U there
just too many questions that I have um to approve anything at this point in time. >> Madam Chair, may I? >> Yes. >> Um Mrs. Is it amanable or is it possible for us to get more information maybe have them
table it at this meeting if the future? >> Yep. I mean if there's if there's interest absolutely >> it's not time sensitive. They'll take our money anytime. I know they will. >> You know and I can find out from our agent but I mean if it is time sensitive
um then I I'll be pulling my recommendation. Right. Well, I would imagine >> I would imagine just I guess I shouldn't speculate, but I would have to think this is not an elected situation by an individual that would require open enrollment. It's just something that's
it's another service. It's like put another roll of toilet paper in the bathroom. >> I thought the way it was described I thought was another option for the employees to choose and it was their it was their choice. But I I would be fine withdrawing my motion. Fine. Okay. And
Mr. um does this plan impact the proposed insurance an insurance rate >> it it could um and again without that data but what I'm hearing it could impact it by you know up to 2% because
it's showing that our in blue cross blue shield the things the measures that we're trying to to take to offset our our cost or reduce our cost >> if it was a comp a local company, >> right? >> But this is somebody that's not local and we're trying to do business and such. So I
>> I mean, if Blue Cross Blue Shield's playing that card, I maybe we need to look for a different carrier. >> Two things I go back to this is economics. I don't care if a single person uses it. If it saves us money over the cost, rock and roll. >> 2% is probably >> 2% is probably more than 60,000,
whatever this is. >> But if they're playing this 2% game with us, that's >> Yeah. I I don't care. Find the This is what I'm saying. There's no numbers here for me to make a decision right now. This is back. So So with that information, I'm I don't know if we need a motion to table, but I can make a motion to motion to table. Well,
Commissioner Vaguely withdrew your motion and Commissioner Meer. Okay, so that's off. So Commissioner Elie, is it a motion to table? >> Motion to second. >> All right, we have a motion to table. All those in favor say I. material. >> The one comment I might make is that
Blue Cross Blue Shield has a you know like a whole floor of actuaries. >> They do by that they have a reason that they say 2% so that they must have some kind of guesstimate of what they think. >> Yeah. And that's what I would >> Well, but if they're saying 2% and we didn't commit to this, but they figured
the quota, you know, don't let them play bush league with us that they're going to jack our rates up 2% because we didn't go with something like this. >> And then I'd negotiate a 30% reduction first year trial fee. >> Yeah, >> there you go. >> Yeah, I'd be pretty upset with them as a upstanding business partner. Commission
or Attorney Son, >> if I could say one more thing, as I think you mentioned before, Commissioner Ward, Bluec Cross Blue Shield does have a lot of incentive programs that employees could take advantage of. And that's why I thought this was a little weird um to have this in addition to
that. I mean, even, you know, like for >> Yes. >> those of us who are seniors, there's the silver, what are they called? >> Silver sneakers. >> Sneakers. Yeah. you know, and there used to be where you could go to the Y and if you went 20 times, you'd get but you know, some of those incentives to
improve the health of our members. So that we do see those reductions in >> Yeah. just through their own programming, not some other >> big on that. So >> well and it's it's the reason too where part of
part of the large incentive coming for people to take care of themselves they have to realize the pain out of pocket >> if it goes in a scenario where they don't recognize that and it's funded through the government funded through some other way what's the incentive
because now it's a cost shared system. So keeping healthcare in the private sector in in itself is an incentive for people to continue to take care of themselves just like these incentivized programs are to go to the gym, go to whatever because ultimately they're hey rather than I want a new phone, I want a
new car versus I don't want to take care of myself. So okay, rather than pay the >> insurance more information will come back. >> That's my thought. >> All right. Okay. >> Can I just clarify? Is it okay? Um, so if if this rate and again the reason what the numbers I'm speculative I mean
that's what they tell us but I don't have anything in writing that's why I didn't produce that but I mean if it is that well we got to give you because we got to look at open enrollment too. So, if the issue is they can't give me any true data on this and you know, we need to get our lock our rates rock our rates
locked in. I mean, I think I'm probably have to move on on our rates. Um, I mean, two weeks. I'm not sure. So, I guess my my question is if if they say that, you know, with >> who's they Blue Cross Blue Shield,
looking at our rates, getting our rates in because we, like I said, we got open enrollment and stuff coming up. We need to get that locked into the budget and everything. Um, >> is it okay to wait two weeks? >> Yeah. >> I mean, okay. >> I mean, you tell us. Is it or do you need this decide decided tonight? >> Well, I'm not going to push to get it
decided tonight. I mean, if if I can get a 26 rate through our broker and we don't have Cava or Cavo, excuse me. Um, Kadiva. Um, >> I I I think this comes secondary in all situations until we prove that there's a savings. >> Okay, perfect.
>> But I the 2% is a savings. >> That's what I'm saying. We can prove that. That's one thing. Otherwise, it's secondary. >> But I haven't heard that from Blue Cross Blue Shield. >> No, you're saying the broker. >> Yeah, the broker. >> The broker to work a little harder because there's other brokers to go to. We want to see the bruises. >> All right. All right. We'll get them.
>> Yeah. >> Okay. If it comes down to it, you can always call a special meeting for if you'd have to. >> I mean, the potent Sorry, >> Commissioner. >> The potential for cost savings could be enough to warrant that meeting. >> That's right. >> Okay. Perfect. >> Yes. >> That's right. Yeah. >> Right. >> Thank you.
>> But there again, maybe we approach Gunderson or Winona Health. Do you have a pro? You know, I'd rather spend my money locally than some company in. >> Okay. >> All right. Thank you. >> Unknown. All right. Thank you. Thank you, Todd. Okay. Committee reports and
communications. Commissioner Begley, >> two things. First of all, it was wonderful to see Farmade in Minnesota for the first time. It's Lily and the gang. Uh 40 years of Farm Aid. >> Yeah. >> Um I love the focus on small and mediumsiz farms. Um I love everything
about it. I love the fact that it was in Minnesota. I went to a farmade concert over 30 years ago. Was in Iowa, etc. But that was just a beautiful thing to see in Minnesota. Um secondly, just a small quick personal note, my son is getting married this Saturday um in Brainard,
Minnesota. Congratulations. >> Be out of town Thursday through Sunday, but really looking forward to that. Um it's our first wedding of the kids. So that's some big news for us. >> You become a father-in-law. It's a different role. >> So looking forward to that. >> Congratulations, Commissioner Eling.
>> Oh, just a couple things. I'm still um seems to be no matter where I go, I get caught on this gun gun law situation. So, still having some good conversations about that and they've been >> all very rational conversations. I really appreciate that. Um for the, you
know, for the most part and so that's good. Um next thing is uh harvest is uh really gotten underway, especially corn silage. You're going to continue to see that ramp up here in the local area. Obviously down south, it's been going for a while. So everybody be cautious,
be careful for those people that listen to this later on. There's not too many people here today. But uh again, just uh take the extra time. There's 30 seconds is not worth anybody getting killed. Um yeah, uh that's uh I think everything I have.
>> Okay. Um Sunday the 4 Winona County 4 No. Yeah, Sunday is having their fall harvest and that's over at St. Charles at the fairgrounds. >> That's the other one I had. Sorry. Thank you. um that I think they have a meal that starts at 11. They have a silent auction, a live auction. Uh it's a big
fundraiser if if people are in the neighborhood, stop by uh the fall harvest. And then um Thursday night, we have an u extension meeting, but we're going to have a presentation and it's uh through um the University of Minnesota and it's called transfer of wealth
opportunity and it's through the department at the University of Minnesota and I Lisa Dirk sent something out. But I don't know if she sent it to everybody or just the extension me. I'm not sure what it it it's Winona County specific some data and stuff and and I'm not sure how it all plays out, but it
should be interesting because it it's something that they're doing across the the state in Winona County. Um we obviously have a lot of wealth, but how do we transfer it and keep the bigger thing is how do we keep it here? Um, so that'll be actually Thursday night and I don't know, I think that's just an in-person meeting, but I know we'll get
hard copies and copies and we can share with everybody that wants to know, but it sounds kind of interesting. Um, and such. So, with that, um, >> motion to Yeah. >> motion to adjurnn. >> I'll second that. >> We have a motion by Commissioner Elen, second by Commissioner Vegley to adjurnn. Any further discussion? All
those in favor say I. Nay. We're Thank you.