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Human Services Board - Agenda - 6/22/2023
K:Agendas & Minutes/DHS Board/Agendas/2023 FROM: Elizabeth Skulan, Director DATE: June 14, 2023 RE: MEETING NOTICE The Bayfield County Department of Human Services Board will hold the regular monthly meeting, Public Hearing on the 2023 DHS Budget, and Opportunity for Comments regarding Bayfield County’s Policies and Procedures for Equal Opportunity in Employment, Service Delivery, and Language Access on Thursday June 22, 2023, at 4:00 p.m. An in person and remote meeting will originate from the County Board Room of the Bayfield County Courthouse, Washburn, Wisconsin. Remote participation is available via Microsoft Teams or by phone using the information below. Microsoft Teams meeting Join on your computer, mobile app or room device Click here to join the meeting Meeting ID: 238 348 703 171 Passcode: 2VucRw Download Teams | Join on the web Or call in (audio only) +1 715-318-2087,,290790352# United States, Eau Claire Phone Conference ID: 290 790 352# Find a local number | Reset PIN Notice is hereby given, in the event the standing committee does not have a quorum, the County Board Chair or Vice Chair may act as an ex officio member (County ordinance, Chapter 3, section 2-3-1(c). Any person wishing to attend who, because of a disability, requires special accommodations, should contact the Department of Human Services at 715-373-6144, at least 24 hours before the scheduled meeting time, so appropriate arrangements can be made. Department of Human Services 117 East Fifth Street P.O. Box 100 Washburn, WI 54891 - 0100 Telephone (715) 373 - (715 Fax 6144 - )373 - 6130 Email: baycodhs@bayfieldcounty.wi.gov K:Agendas & Minutes/DHS Board/Agendas/2023 The agenda: Approval of the May 25, 2023, Meeting Minutes; Program Presentation; Open Floor for Public Hearing for Public Comment, Input on 2024 DHS Budget, and Comments Regarding Bayfield County’s Policies and Procedures for Equal Opportunity in Employment, Service Delivery, and Language Access; 2024 Budget Guidance; 2024 DHS Budget Priorities; Department Section Reports; Monthly Financial and Training Reports; Close Floor for Public Comment; Informational Items; and other business that may come before the Board. c: County Board Chair County Board of Supervisors Post (bulletin boards and website) e-mailed: DES, Ashland Health Department DCS, Rhinelander New Day Shelter Greater Wisconsin Agency on Aging Resources, Inc. Daily Press County Journal 1 Department of Human Services 117 East Fifth Street P.O. Box 100 Washburn, WI 54891-0100 Telephone (715) 373-6144 Fax (715-)373-6130 Email: baycodhs@bayfieldcounty.wi.gov BAYFIELD COUNTY DEPARTMENT OF HUMAN SERVICES BOARD MEETING PUBLIC HEARING ON THE 2023 DHS BUDGET OPPORTUNITY FOR COMMENTS REGARDING BAYFIELD COUNTY’S POLICIES AND PROCEDURES FOR EQUAL OPPORTUNITY IN EMPLOYMENT, SERVICE DELIVERY, AND LANGUAGE ACCESS James Crandall (Chair) Marty Milanowski Mary Dougherty Jeremy Oswald (Vice Chair) Madelaine Rekemeyer Susan Rosa Lona Schmidt Stephanie Defoe-Haskins Patrick Irvine RE: June 22, 2023, Department of Human Services Board, Public Hearing on the 2023 DHS Budget, and Opportunity for Comments Regarding Bayfield County’s Policies and Procedures for Equal Opportunity in Employment, Service Delivery, and Language Access Notice is hereby given, in the event the standing committee does not have a quorum, the County Board Chair or Vice Chair may act as an ex officio member (County ordinance, Chapter 3, section 2-3-1(c). Dear Committee Members: Please be advised that the monthly meeting and Annual Public Hearing of the Bayfield County Department of Human Services Board and Opportunity for Comments Regarding Bayfield County’s Policies and Procedures for Equal Opportunity in Employment, Service Delivery, and Language Access will be held on Thursday, June 22, 2023, at 4:00 p.m. in the County Board Room. Remote connectivity is available. The meeting will originate from the Bayfield County Board Room on the second floor of the Bayfield County Courthouse, Washburn, Wisconsin. Remote participation is available via Microsoft Teams, a link, phone number, and conference ID are included on page 2. 2 Microsoft Teams meeting Join on your computer, mobile app or room device Click here to join the meeting Meeting ID: 238 348 703 171 Passcode: 2VucRw Download Teams | Join on the web Or call in (audio only) +1 715-318-2087,,290790352# United States, Eau Claire Phone Conference ID: 290 790 352# Find a local number | Reset PIN Individuals who wish to provide input on the 2023 DHS Budget or comment on Bayfield County’s Policies and Procedures for Equal Opportunity in Employment, Service Delivery and Language Access remotely can indicate they would like to speak. They will be recognized by the Chair and invited to speak when the Floor is Open for the Public Hearing. The Floor will be open after the program presentation until the end of the meeting to accommodate the public. Any person wishing to attend who, because of a disability, requires special accommodations, should contact the Department of Human Services at 715 -373-6144 at least 24 hours before the scheduled meeting time, so appropriate arrangement can be made. The agenda for this meeting is as follows: AGENDA 1. Call to Order 2. Welcome and Introductions 3. Discussion and Possible Action - Review of the May 25, 2023, Meeting Minutes 4. Program Presentation – Dementia Live Presentation, Ellie Webb, Dementia Care Specialist 5. Action - Open the Floor for Public Hearing for Public Comment, Input on the 2024 DHS Budget, and/or Bayfield County’s Policies and Procedures for Equal Opportunity in Employment, Service Delivery, and Language Access 3 6. Opportunity for Public Comment, Comments on the 2024 Budget, and/or Comments Regarding Bayfield County’s Policies and Procedures for Equal Opportunity in Employment, Service Delivery and Language access. (Limit 3 minutes please.) 7. Review Any Written Comments 8. Monthly Section Reports A. Economic Support Services – Jeanine Spuhler B. Family Services – Mary Anich C. Support Services – Stephanie Eder D. Behavioral Health and Community Services – Tom Croteau E. Aging & Disability Services – Carrie Linder 9. Monthly Reports A. Financials B. Training 10. 2024 Budget Guidance - Preparation Memo to Department Heads from County Administrator Mark Abeles-Allison, May 31, 2023 11. 2024 DHS Budget Priorities 12. High-Cost Pool Fund for Tribal Placements Award 13. Action - Close the Floor to Public Comment, Public Comment on the 2024 Department of Human Services Budget, and Comments Regarding Bayfield County’s Policies and Procedures for Equal Opportunity in Employment, Service Delivery and Language Access 14. Other (Informational Items) A. B. 15. Future Meetings A. July/August Combined Meeting, Thursday, August 17, 2023 4 B. September 28, 2023 C. October 26, 2023 16. Motion or Chair’s Announcement to Adjourn Thank you and have a safe trip home! Sincerely, Elizabeth A. Skulan Elizabeth A. Skulan, Director c: Mr. Mark Abeles Allison, County Administrator Bayfield County Board of Supervisors Bayfield County Department of Human Services Board Bayfield County Department of Human Services Managers Lynn Divine, Bayfield County Clerk Email to: Other Interested Parties Requesting K/agendas & minutes/DHS Board/agenda 6-23-22 BAYFIELD COUNTY HUMAN SERVICES BOARD MEETING EOC & Virtual May 25, 2023 K:\Agendas and Minutes\DHS Board\Minutes\2023 DHS Board Minutes\2023-05-25_BCDHS_Board_meeting_minutes -DRAFT.docx 1 Board Members Present: Jeremy Oswald, James Crandall, Patrick Irvine, Lona Schmidt, Marty Milanowski*, Stephanie Defoe-Haskins*, Sue Rosa, Mary Dougherty* (*attended virtually) Not Present: Madelaine Rekemeyer Others Present: Elizabeth Skulan, Carrie Linder, Tom Croteau, Mary Anich, Jeanine Spuhler, Stephanie Eder, Sarah Traaholt, Val Levno Call to Order and Introductions Crandall called the meeting to order at 4:00 p.m. Introductions were made. Opportunity for Public Comment (Limit 3 minutes please.) No Public Comment Discussion and Possible Action – Review and approval of the April 27, 2023, meeting minutes. Schmidt noted that her attendance was in person not virtual. With Schmidt’s attendance change, minutes were approved. Motion by Milanowski, second by Schmidt to approve the April 27, 2023, meeting minutes with Schmidt’s attendance change. Motion passed. Program Presentation – Comprehensive Community Support Annual Survey, Val Levno, CCS Administrator, Ashland and Bayfield County Region • Levno states that Bayfield County Comprehensive Community Services (CCS) staff is doing a great job and Tom Croteau is an excellent leader. • Comprehensive Community Services statewide uses a variation of the Mental Health Statistics Improvement Project (MHSIP) survey that is used by the Federal Substance Abuse and Mental Health Services Administration. Service Facilitators hand deliver surveys to participants who have been in the program for six-months or more. Surveys are confidential and voluntary. Survey questions include participant experiences, relationships and interaction with staff, services offered and growth of the participant. • Levno reviewed results of 2022 MHSIP survey that went out to twenty-five active participants and four discharged participants. Response rate was 79% overall, 92% without discharges, which is an excellent return rate. Bayfield County scored above or at the State mean score of 3.5. • Levno noted that the pandemic was very difficult for individuals with mental health and substance use issues. She said it is good to see that participants are utilizing services and having positive interactions and results. • Results of the survey help to drive program goals for the following year. Goals for 2023 include: increasing contracted providers of home and community services by 5%; increasing MHSIP Adult man domain score of “I feel I belong in my community” to 3.6 mean score; and increasing MHSIP Adult mean domain score of “I do better in social situations” to 3.9 mean score in Bayfield County. DRAFT: Subject to change at the next BCDHS meeting BAYFIELD COUNTY HUMAN SERVICES BOARD MEETING EOC & Virtual May 25, 2023 K:\Agendas and Minutes\DHS Board\Minutes\2023 DHS Board Minutes\2023-05-25_BCDHS_Board_meeting_minutes -DRAFT.docx 2 Monthly Section Reports Support Services – Stephanie Eder • Deanna Regan accepted the Office Manager position in Forestry. Regan’s last day in Human Services was May 15, 2023. We wish her all the best. • Eder noted interviews are scheduled for the vacant Clerk position. A joint interview with Economic Support was held today for a candidate who applied for both vacancies. Two more interviews are scheduled for Tuesday, May 30, 2023. • Eder stated information for the annual report is being compiled and assembled. • Audit preparation is complete. Auditors will be conducting a remote audit the week of June 26, 2023, and an onsite audit the week of July 10, 2023. Aging & Disability (A&D) Services – Carrie Linder • Linder presented a handout for World Elder Abuse Awareness Day (WEAAD) activities. World Elder Abuse Awareness Day is June 15, 2023. A variety of activities are planned for that week. Activities and information will be provided at the Farmer’s Market and Music in Legion Park on June 14, 2023. There will be a health fair including presentations on Power of Attorney Abuse and Undue Influence, Cognitive Decline and Diminished Capacity and Scams and Identity Theft on June 15, 2023. Banking and Law Enforcement presentations will be provided to local agencies on June 16, 2023. Finally, “Grandpa and Lucy”, a story about love and dementia will be shown at 6:00 p.m. at Stage North on June 17, 2023. and is free to the public. • Staff have been busy with outreach. Marianne Johnson is offering “Medicare 101” presentations for Bayfield County residents approaching sixty-five. Johnson has also been working on the 2023 Farmer’s Market Nutrition Program Voucher Distribution. Michelle Reiswig is hosting a series of Power of Attorney (POA) workshops throughout the county and virtually. Kristin Opperman and Hayley Weyers travelled to Bayfield and Drummond parents’ nights to present on Children’s Long-Term Services (CLTS). Economic Support Services – Jeanine Spuhler • Sphuler noted Economic Support Services is getting numerous calls regarding the public benefits unwinding in a volume she has not been seen in years. • The Economic Support (ES) team has been busy processing health care renewals in addition to regular on-going work. • The State of Wisconsin is emphasizing the message for applicants to wait until their renewal is due to renew benefits. • Frontline workers and supervisors are either learning or becoming reacquainted with pre- pandemic requirements. • Trainings, meetings, and emails are keeping everyone busy. • The state has hired a team of Limited Term Employees (LTE) whose services can be deployed throughout the state IM consortia to assist with the additional work caused by the unwinding at no cost to the consortia. • The Northern Income Maintenance Consortium (NIMC) has two workers from this team available for the next few months. BAYFIELD COUNTY HUMAN SERVICES BOARD MEETING EOC & Virtual May 25, 2023 K:\Agendas and Minutes\DHS Board\Minutes\2023 DHS Board Minutes\2023-05-25_BCDHS_Board_meeting_minutes -DRAFT.docx 3 • Northern Income Maintenance Consortium hosted an all staff meeting on May 11, 2023. The meeting was held remotely, but it was a good opportunity for NIMC workers in all 12 counties to come together to meet and train. • Wisconsin Home Energy Assistance Program (WHEAP) wrapped up the 2022-2023 program year on May 15, 2023. WHEAP program runs annually from October 1st – May 15th. • Spuhler reported notice was received that another heating payment for those determined eligible for the Wisconsin Home Energy Assistance Program will be issued sometime this summer. Payment amounts are expected to average $500 and will be paid to heating vendors. • The state is also planning to offer a Summer Fill program for eligible households that heat with propane or fuel oil. • IM staff collaborated with Aging and Disability Services and IRIS for two clients who needed furnace equipment switched from fuel oil to propane. • Working on internal quality assurance reviews for WHEAP. Reviews happen twice a year. • Quality compliance for Food Share Management Evaluation Review (MER) has taken place. More information will be presented at the next meeting. • Spuhler stated ES had one worker out for two weeks due to an injury. • Interviews were held. Spuhler reported there were two good candidates for the vacant ES position. • Purchase request has been submitted for technology related items for ES workers. This will be the last opportunity for NIMC counties to purchase equipment using ARPA funding. Family Services – Mary Anich • Anich attended a meeting with the new Indian Child Welfare Director, Juliet Means to discuss mandatory reporting. • Staff of some agencies such as school staff, law enforcement, medical staff and mental health field staff are required to report suspected child abuse to the county child welfare agency. They can also choose and are encouraged to report to Indian Child Welfare as well, but this in not mandated. Anich and staff are working with the Sheriff’s Office and Red Cliff to make sure that mandatory reporting processes are followed. • Anich and Briana Aldaba met with Red Cliff Indian Child Welfare to discuss foster care licensing issues. Bayfield County pays all Red Cliff foster providers but the Tribe can issue foster care licenses to tribal providers. • Anich is busy completing performance evaluations for new staff. • Family Services staff are becoming more and more confident, independent, and are working well together as a team. • Family Services still has one vacancy. • Anich is in discussion with Skulan about reinstating the Coordinated Services Teams (CST) program. • Anich stated Youth Justice referrals are increasing. • Anich noted summer provides more flexibility to meet with families. BAYFIELD COUNTY HUMAN SERVICES BOARD MEETING EOC & Virtual May 25, 2023 K:\Agendas and Minutes\DHS Board\Minutes\2023 DHS Board Minutes\2023-05-25_BCDHS_Board_meeting_minutes -DRAFT.docx 4 Behavioral Health & Community Programs – Tom Croteau • Croteau is pleased to announce that Hailey BeBeau joined the behavioral health team on May 8, 2023, as a Behavioral Health (BH) Care Case Manager. BeBeau brings a lot of positive energy and enthusiasm and fits well with the team. • Behavioral Health continues to see an increased number of emergency detentions. The team works with Corporation Counsel to process the detentions then they provide support to the individuals who have been hospitalized or placed in treatment when the individuals return home and back in the community. • The increased numbers of emergency detentions and residential placement for the first four months of 2023 has resulted in an increase in spending for these mandated services. • The Comprehensive Community Services (CCS) census continues to grow. CCS currently has forty- nine active participants, with three participants to be discharged soon. Service Facilitators will work with participants to prepare for discharge. • Croteau notes the CCS team includes three full-time facilitators. Three other staff, two Behavioral Health Case Managers and Family Specialist Val Westlund, are also providing five to nine hours a week to the program. One limited term employee, August Gordon, will be here through the summer. She also provides services to CCS participants. • As the 2024 budget planning process begins, Skulan and Croteau are advocating for another Mental Health Professional/Service Facilitator to support the needs of participants in the growing program. • Irving questioned the increase in CCS clients. Croteau attributes climbing numbers to rebuilding the program, word of mouth, networking, public education and outreach. • Skulan reported there were 69 participants when New Horizons North, Inc. filed for bankruptcy and went out of business. The program is slowly growing as trust is being built in new providers and services. Croteau guestimates the participant numbers will plateau around 75. • Croteau noted the reimbursement to the county for CCS expenses is close to 100%. Monthly Reports Monthly Financial and Training reports were reviewed and placed on file. Discussion and Possible Action – Consideration and request to recommend to the County Board Chair the appointment of citizen member Lona Schmidt for another term to the Human Services Board. Lona has indicated her willingness to another term on the Human Services Board and DHS is seeking a formal recommendation to the County Board Chair. Motion by Oswald, second by Milanowski to recommend the appointment of citizen member Lona Schmidt to the County Board Chair for another term to the Human Services Board. Motion passed. Discussion – Review of Opioid Epidemic – Bayfield County Community Needs Survey. A total of 544 surveys were completed, 511 were completed by Bayfield County residents, a 6.70% return rate, given the 7,928 notices issued. The workgroup met to review the responses. There was consensus with the majority of survey responses that the money should be focused at and invested in BAYFIELD COUNTY HUMAN SERVICES BOARD MEETING EOC & Virtual May 25, 2023 K:\Agendas and Minutes\DHS Board\Minutes\2023 DHS Board Minutes\2023-05-25_BCDHS_Board_meeting_minutes -DRAFT.docx 5 prevention. Public Health is reaching out to CESA 12 to determine if there is a way to partner with them to provide Evidence Based curricula and prevention strategies in the local school districts. There was some discussion on mental health services, alliances and groups in the area. 2024 Budget Public Hearing Process Overview – 2024 Budget Public Hearing Process was reviewed. Other (Informational Items) • Data Regarding Medicaid Expansion – e-mail Nathan Bollhorst, WI Department of Administration. • Email complimenting performance of Behavioral Case Manager, Jamie Allen. • Recognition form Northern Income Maintenance Consortium Monthly Newsletter highlighting state feedback regarding call made to Economic Support Specialist, Jessica Soulier. Future Meeting Dates • June 22, 2023 – this meeting will include the Public Hearing on the 2024 Budget and Opportunity for Comments Regarding Bayfield County’s Policies and procedures for Equal Opportunity in Employment, Service Deliver, and Language Access and will be held in the County Board Room. • July 27, 2023 • August 24, 2023 Crandall Adjourned the meeting at 5:37 p.m. Submitted by Sarah Traaholt, Clerk III People often confuse the terms dementia and Alzheimer’s. But there are definite differences between them. Dementia is an umbrella term that describes a group of symptoms affecting memory, thinking, and social abilities severely enough to interfere with daily functioning. Dementia is not a specific disease. It is the symptom of a disease. There are many conditions that can result in symptoms of dementia. Some dementia is reversible. In this case, dementia is caused by a condition that is treatable. When the underlying problem causing dementia symptoms is identified and treated, the dementia symptoms clear. Reversible Dementia Causes Reversible conditions include: ·· Depression ·· Infection ·· Medication side effects ·· Vitamin/mineral deficiencies ·· Dehydration ·Thyroid problems ·· Hydrocephalus ·· Hypo/Hyperglycemia ·· Delirium Irreversible Dementia Types Irreversible dementia occurs when a disease results in permanent brain damage. Some of the more common irreversible causes of dementia include: Alzheimer's disease,the most common, is a progressive brain disease that damages brain cells. Brain changes lead to growing trouble with memory, thinking and reasoning, judgement, performing familiar tasks, changes in personality and behavior, and decreased physical function. Vascular dementia caused by brain damage from impaired blood flow, such as stroke. Symptoms vary depending on the part of the brain where blood flow is impaired. Symptoms often follow a more stepwise deterioration followed by a period of relative recovery. Frontotemporal dementia is a progressive condition which predominantly affects behavior and personality. Lewy body dementia causes a progressive decline in mental abilities. Visual hallucinations and Parkinson's disease-like symptoms such as rigid muscles, slow movement and tremors are common. Parkinson’s disease is a progressive disorder of the nervous system that affects movement. 50-80 percent develops dementia as their disease progresses. Dementia, whether it is reversible or irreversible is a loss of mental function that can affect language, memory, visual and spatial abilities, or judgment. What is Copyright ©2016 - AGE-u-cate Training Institute ®AG cateEu Training Institute Copyright ©2016 - AGE-u-cate Training Institute ®AG cateEu Training Institute D E M E N T IA UMBRELLAGradual Progressive Decline That Impacts Everyday Life - Depression - Infections - Medication/Drug Interaction - Hydrocephalus - Vitamin/Mineral Deficiencies - Hypo/Hyperglycemia Reversible - Alzheimer’s Disease - Vascular Dementia or Multi-Infarc - Frontotemporal Dementia - Parkinson’s Disease - Creutzfeldt-Jakob Disease - Lewy Body Disease - Huntington’s Disease Irreversible Mem o r y Moo d Pers o n a l i t y Prob l e m Solv i n g Beh a v i o r Lang u a g e Judg e m e n t Com m u n i c a t i o n Sens e s Dementia Effects Each Participant will need: - Sunglasses - A pair of gloves - Glass of water, tea, coffee, or another beverage - Wallet or purse (with wallet inside) - Pad of paper - Pen - Paperclips - Sticky Notes - Cell Phone - Magazine Better Communication & Understanding Dementia gradually diminishes a person’s ability to communicate..Here are ways to help you better communicate with a person living with dementia. TIPS FOR EFFECTIVE COMMUNICATION •Eye contact is always best! Position yourself on their level and establish direct eye contact. Speak calmly in a normal tone of voice. A gentle hand touch can be an effective tool for engaging with a person living with dementia. •Listen with understanding and interest. Dementia does not take away a person’s feelings or the need to be understood. Validate concerns and help the best your can. •Keep conversations short and simple. Dementia often challenges a person’s ability to process information quickly. Slow down and give the person time to process and respond. Silently count to 10 before moving on. •Never argue! As their care partner, it’s your job to creatively step into their world with empathy, understanding, and love. •Reminisce. People living with dementia often find security and peace by sharing old memories and life stories. When things become overwhelming or difficult, do your best to shift the conversation. Empowerment Tool How are you feeling? Circle how you are feeling right now after the Dementia Live Experience. You may be feeling more than one emotion. There is space to add different emotions, if you experienced them. Angry Annoyed Anxious Bored Confused Depressed Determined Foolish Frustrated Inadequate Irritated Lonely Lost Miserable Overwhelmed Scared Silly Tense Terrified Worried Worthless There is space for you to add how you are feeling now…