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HomeMy WebLinkAboutHuman Services Board - Minutes - 8/17/2023BAYFIELD COUNTY HUMAN SERVICES BOARD MEETING EOC & Virtual August 17, 2023 K:\Agendas and Minutes\DHS Board\Minutes\2023 DHS Board Minutes\2023-08-17_BCDHS_Board_meeting_minutes-final.docx 1 Board Members Present: Jeremy Oswald, James Crandall, Patrick Irvine, Lona Schmidt, Mary Dougherty (arrived at 4:02), Sue Rosa*, Marty Milanowski (*attended virtually) Not Present: Madelaine Rekemeyer, Stephanie Haskins-Defoe Others Present: Elizabeth Skulan, Tom Croteau, Mary Anich, Stephanie Eder, Sarah Traaholt, Val Gurske-Westlund Call to Order and Introductions Crandall called the meeting to order at 4:02 p.m. Introductions were made. Discussion and Possible Action – Review and approval of the June 22, 2023, meeting minutes. Motion by Schmidt, seconded by Milanowski to approve the June 22, 2023, meeting minutes. Motion passed. Program Presentation – Parenting Assessment and Family Specialist Role Presentation, Family Specialist Val Gurske-Westlund, Family Services Anich introduced Val Gurske-Westlund to the Board. Anich noted that Gurske-Westlund came to the Department of Human Services (DHS) two years ago and brings a wealth of knowledge, skills, life experience and history of advocacy to the Family Specialist position. Gurske-Westlund noted that her background in probation and parole and position with the New Day Shelter made this position an easy transition for her. The role of a Family Specialist is to ensure child safety by working with families involved with Child Protective Services to assist them in improving their parenting and household management skills and to help them develop positive coping mechanisms. Participants can be court ordered or voluntary. Gurske-Westlund shared some of the different tools used with families including the parenting assessment included in the Board packet. The parenting assessment is a set of questions integrated into conversations with families to gauge where they are at and pinpoint needs. Gurske-Westlund involves families in the case planning and together they set goals. The plans require goals and how success will be measured is identified with the Family Specialist. Gurske-Westlund helps families find tools and resources to help them move toward their goals to establish a productive and healthy family environment. Anich stated that due to fluctuating caseloads and capacity, Gurske-Westlund has taken the training necessary to work in the Comprehensive Community Services (CCS) program. Gurske-Westlund provides FINAL: Approved at the 9/28/23 BCDHS meeting BAYFIELD COUNTY HUMAN SERVICES BOARD MEETING EOC & Virtual August 17, 2023 K:\Agendas and Minutes\DHS Board\Minutes\2023 DHS Board Minutes\2023-08-17_BCDHS_Board_meeting_minutes-final.docx 2 direct service to CCS participants. She also worked with the Family Services youth justice staff when needed. Anich indicated Gurske is a valued member of the Family Services team. Opportunity for Public Comment (Limit 3 minutes please.) No Public Comment Monthly Section Reports Economic Support Services – Jeanine Spuhler Spuhler was on vacation and unable to attend the meeting. Support Services – Stephanie Eder • Support Staff reception position is still open. Vacancy was posted three times. Two interviews are scheduled for Monday. Hoping to find a good fit and fill the position. • Support Staff member was out for a few weeks after surgery. • Working as a team to make sure tasks and adequate coverage for vacancy, surgery and summer vacation schedules. Behavioral Health & Community Programs – Tom Croteau • Behavioral health continues to process many emergency detentions (ED). Behavioral Health staff provide support for individuals who have been hospitalized due to their mental health and/or addiction through various treatment options, voluntary and involuntary, and case management. This includes providing support to individuals transitioning from placement back to their homes and communities. There have been several emergency detentions conducted on individuals who reside in another county or state. In Wisconsin, counties are mandated to ensure that individuals found within the county who need emergency mental health or substance use disorder services receive them. Once emergency services are provided, the case is transferred to the individual’s county or state of residency. • Croteau noted there are many individuals currently seeking voluntarily services. Hailey BeBeau, Behavioral Health Case Manager, received five requests in a single day for voluntary services. Croteau attributes this to outreach and educating other departments and professionals regarding the services that are available. While not mandated, providing voluntary services may help reduce the cost of care if they prevent emergency situations. • Behavioral Health staff, Croteau, and Skulan met with Corporation Counsel to discuss the steps required to process emergency detentions. Croteau noted MMC will be hosting an event in September to review the process and ensure staff in agencies who process emergency detentions understand the legal requirements. • Croteau reported on the positive outcomes of two clients who been in treatment multiple times who are now enjoying some stability. One has transitioned back into community. BeBeau worked extensively with this client to ensure everything was in place for a successful transition. The other client found success with new medications and outside providers. Positive outcomes are good for clients and staff morale. BAYFIELD COUNTY HUMAN SERVICES BOARD MEETING EOC & Virtual August 17, 2023 K:\Agendas and Minutes\DHS Board\Minutes\2023 DHS Board Minutes\2023-08-17_BCDHS_Board_meeting_minutes-final.docx 3 • Irvine inquired whether there were adequate psychiatrists in the area. Croteau noted there is a lack of providers for most medical professionals in the area as providers are scarce. He reported there are no child psychologists in the area and one child current psychiatrist will be moving and will be serving local children virtually only. • Crandall inquired about secure detention facilities. Croteau stated the closest locked state mental health institution is Winnebago. Irvine stated he finds the lack of providers worrisome. Croteau states that depression, substance abuse and complex children’s cases are increasing. Croteau reported that Douglas County will open a peer run crisis bed in approximately one year for voluntary placements. Anich noted Northland Counseling has the infrastructure for a youth crisis facility, but they have been unable to attract the staff to open. • Croteau noted a law has been proposed to allow Advanced Practice Nurse practitioners who have worked two years under a physician’s supervision to practice independently of physicians. This might positively affect the number of providers available in the future. • Croteau noted CCS currently has several new intakes. CCS currently has more intakes than discharges. This comes at a time when staff are already stretched due to caseloads. • Croteau received notice that the contracted provider who completes substance abuse screens is ending the contract. Croteau states that this change will shift some clinical time back to him. However, the team has been working to develop a plan for other staff to become qualified to complete the screens. • August Gordon’s limited-term employment ended last week. Gordon is pursuing her master’s degree. • CCS staff continue to work through issues related to using EchoVantage, the new electronic health record (EHR). • Chequamegon Bay Overdose Awareness Day Virtual 5K walk/run will be on August 31st. Overdose Awareness Day is recognized internationally every year on August 31. This year, area organizations, coalitions, committees, and groups have banded together to organize an event to raise awareness about the overdoses occurring locally. The event is free and open to the public. The first 200 participants registered for the event will receive a medication lock box that includes information about overdose and local resources including those available at Bayfield County. Aging & Disability (A&D) Services – Carrie Linder Linder was unable to attend the meeting. Family Services – Mary Anich • DHS said goodbye to August Gordon. She was hired in late 2021 as a behavioral health case manager. She transitioned to a youth justice case manager, then served as an intern and limited term employee in CCS while she attended her first year of grad school. August continued to support the family services unit as part of the on-call rotation up until several days before her final day with Bayfield Co. August will be working with the Bayfield School in her final year of grad school. August’s efforts were noted and appreciated. We wish her well. • Anich reported the last several weeks there have been many afterhours calls, primarily for mental health and aging, rather than for child protective services. Family Service’s staff are often asked to trouble shoot mental health, substance use, homelessness situations, adult protective services/dementia issues, and heating and fuel emergencies in the colder months. Anich states on BAYFIELD COUNTY HUMAN SERVICES BOARD MEETING EOC & Virtual August 17, 2023 K:\Agendas and Minutes\DHS Board\Minutes\2023 DHS Board Minutes\2023-08-17_BCDHS_Board_meeting_minutes-final.docx 4 call staff does their best to offer suggestions, but responses to most of the calls are not available until the next business day. • Bayfield Co DHS was awarded a Foster Parent Grant to promote normalcy activities for children in out of home care. The proposal included paying for drivers’ education, work/internship support, cultural activities, sports/clubs/extracurriculars, school trips, school supplies, camps, etc. • Anich attended the monthly Child Care Program Committee call which reviews updates to childcare providers requirements and happenings. • Family Services has one vacancy and one staff member on a brief leave of absence until later August. • Anich and Alice Wilson attended a tour of the proposed new space being rented in Ashland for the forensic interviews of children. Bayfield Co currently uses a room at the sheriff’s offices for these sensitive interviews, which can be very intimidating to children and their families. Bayfield County DHS has partnered with Ashland Co DHHS to rent the space for the next six months. Its use will be reviewed after the first of next year. • Anich also attended a brief overview of how to use the Compressed Natural Gas (CNG) fleet vehicles. County vehicle use has increased substantially. • Hailey BeBeau finished Juvenile Court Intake Training and will now be included in the on-call rotation. • Ashley Maki completed the WiLearn Child Protective Services (CPS) training. Anich states it is a good way to onboard staff and orientate them to CPS. Monthly Reports Monthly Financial and Training reports were reviewed and placed on file. Discussion and Possible Action –2024 Budget – Review of the DHS 2024 Budget Narrative and Budget Reviewed proposed budget documents included in packet. Skulan reviewed narrative for Human Services 235 which is placed in counties budget book and reviewed all budget changes for 2024. Due to an accounting issue that has yet to be decided between County Administration and BakerTilly, the counties auditing firm, Skulan asked the DHS Board to approve the 2024 budget for $6,710,344 and contingently for $7,710,344. The additional $1,000,000 is the total of anticipated 2024 purchases Bayfield County will contract and authorize payment for through the Children’s Long-Term Services (CLTS) program. The funds are paid directly to vendors through the state’s third-party administrator (TPA). The auditors feel these funds should be included in the budget and in the financials as DHS is responsible for the contract and authorization of payment of funds. By approving both amounts, the budget will not be detained if the funds must be added. Skulan explained the Children’s Long-Term Support (CLTS) Program helps children with disabilities and their families through supports and services that help children grow and live their best lives. It is a home and community-based service waiver. It uses a Medicaid waiver to fund services for children with disabilities. A waiver lets states use Medicaid to fund additional non-medical services and supports not BAYFIELD COUNTY HUMAN SERVICES BOARD MEETING EOC & Virtual August 17, 2023 K:\Agendas and Minutes\DHS Board\Minutes\2023 DHS Board Minutes\2023-08-17_BCDHS_Board_meeting_minutes-final.docx 5 normally offered. The CLTS Program aims to keep children at home instead of at an institution. Oswald was thankful for the information on how the program works and noted that placement costs versus buying items to keep the children in the home is much less costly than institutionalization and better for the children. Bayfield County DHS tries to use best practices and alternatives for purchases that minimize cost. Large credit card purchases require the director’s approval. Very high-cost non-standard purchases must be submitted to the state for approval. Motion by Dougherty, seconded by Milanowski to approve the proposed DHS budget for 2024 at $6,710,344 and contingently for $7,710,344 should the decision be made to include pass through CLTS purchases to the budget. Motion passed. Discussion and Possible Action –2024 Budget – Review and Recommendation to present to County Board of Supervisors The first draft of the annual report reviewed. Three changes were noted: updated the budget summary on page 5, repositioned table in graph on page 32, and added one staff to the organizational chart page 55. Crandall had a question related to the historical CCS numbers. Skulan noted Bayfield County took over the program in 2019 when New Horizons North filed bankruptcy. At that time, enrollment dropped. Enrollment also dropped due to the pandemic, 2020 and 2021 face-to-face services were not offered, and many providers laid off direct service staff. The program is still recovering from these events. The census is still growing, and it appears Bayfield County can provide the services more cost effectively than New Horizons North, Inc. had in the past. Crandall also noted the number of children enrolled in the program have tripled. Croteau stated that regional CCS Administrator Val Levno has put considerable effort into outreach efforts to schools which has helped increase referrals. Oswald stated the report includes valuable information. He is excited to have the report to use it to show the community what DHS does. Irvine agreed on the value of the information and the format of the report. Motion by Milanowski, seconded by Schmidt to receive and place 2022 DHS Annual Report with noted changes on file and recommend presentation of the report to the County Board of Supervisors. Motion passed. Discussion and Possible Action – Resolution No. 2023-01, Resolution to Designate the Department of Human Services to Receive Coordinated Services Team (CST) Funding The committee reviewed the resolution and recommended it to the Bayfield County Board of Supervisors. Motion by Oswald, seconded by Milanowski to accept Resolution No. 2023-01 and recommend to full County Board. Motion passed. BAYFIELD COUNTY HUMAN SERVICES BOARD MEETING EOC & Virtual August 17, 2023 K:\Agendas and Minutes\DHS Board\Minutes\2023 DHS Board Minutes\2023-08-17_BCDHS_Board_meeting_minutes-final.docx 6 Discussion and Possible Action – Review application and recommendation to reappoint Beverly Lindell to the Family and Behavioral Health Advisory Committee. Beverly Lindell is an existing member of the committee whose term is expiring. Bev is interested in service another term. Her reappointment was recommended by the committee Family and Behavioral Health Advisory Committee. Motion by Oswald, seconded by Schmidt to approve the reappointment Beverly Lindell to the Family and Behavioral Health Advisory Committee. Motion passed. Discussion and Possible Action – Review applications for the reappointments of participant members Sandra Notzke and Tom Mittelstaedt to the local and regional Comprehensive Community Services (CCS) Coordination Committees. Both Mittelstaedt and Notzke are interested in serving another term. The local and regional CCS Committees have recommended their reappointments. Motion by Schmidt, seconded by Irvine to approve the reappointments of Sandra Notzke and Tom Mittelstaedt to the local and regional Comprehensive Community Services Coordination Committees. Motion passed. Discussion and Possible Action – Reclassification of Christopher Beirl The committee reviewed the materials submitted to Human Resources, the County Administrator, and the Personnel Committee to request the reclassification of Service Facilitator Chris Beirl to Service Facilitator/Substance Abuse Counselor. The Personnel Committee approved the reclassification at their August 9, 2023, meeting. The reclassification was brought to the Human Services Committee to allow them to support the reclassification. Motion by Milanowski, seconded by Schmidt to support the reclassification of Christopher Beirl from Service Facilitator to Service Facilitator/Substance Abuse Counselor. Motion passed. Oswald voiced his appreciation for the foresight on this reclassification which both affords employees the opportunity for professional development and retains employees longer. Grant Award – The committee reviewed the Notice of Award for $5,800 Foster Parent Grant to Bayfield County to improve normalcy opportunities for children provided in the packet. Other (Informational Items) A. Call Quality Review Scorecard for Economic Support Specialist Aaron Kalmon B. Office News, Northern Income Maintenance Consortium (NIMC) Newsletter, highlighting Bayfield County location and work done by Economic Support Specialist Danielle Colby C. Email regarding Adult Protective Services Social Worker Brynna Watters-Moffitt BAYFIELD COUNTY HUMAN SERVICES BOARD MEETING EOC & Virtual August 17, 2023 K:\Agendas and Minutes\DHS Board\Minutes\2023 DHS Board Minutes\2023-08-17_BCDHS_Board_meeting_minutes-final.docx 7 Future Meetings • September 28, 2023 • October 26, 2023 • November/December - December 5, 2023 (Meeting starts at 3:30 with a holiday potluck) Crandall Adjourned the meeting at 5:46 p.m. Submitted by Sarah Traaholt, Clerk III