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HomeMy WebLinkAboutHuman Services Board - Minutes - 5/23/2024BAYFIELD COUNTY HUMAN SERVICES BOARD MEETING EOC & Virtual May 23, 2024 K:\Agendas and Minutes\DHS Board\Minutes\2024 DHS Board Minutes\2024-05-23_BCDHS_Board_meeting_minutes -FINAL.docx 1 Board Members Present: James Crandall, Sue Rosa, Lona Schmidt, Marty Milanowski, Mary Dougherty, Patrick Irvine, Madeline Rekemeyer, Stephanie Defoe-Haskins (virtual) Others Present: Elizabeth Skulan, Mary Anich, Tom Croteau, Carrie Linder, Jeanine Spuhler (virtual), Sarah Traaholt, Brynna Watters-Moffitt Call to Order and Introductions Crandall called the meeting to order at 4:01 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 22, 2024, meeting minutes. Motion by Milanowski, seconded by Rosa to approve the April 22, 2024, meeting minutes. Motion passed. Program Presentation – Aging & Disability Services Brynna Watters-Moffit, Adult Protective Services Social Worker, was introduced to the group. Watters-Moffit reviewed new nationwide federal regulations for Adult Protective Services (APS). Administration for Community Living (ACL) released a final rule to establish the first federal regulations for APS programs. New regulations will take effect on June 7, 2024. States have until May 8, 2028, to fully comply with the new law. Watters-Moffitt notes the change in regulations sets a new national standard, promotes high-quality, and improves consistency in services across states. Watters-Moffit reviewed current practices of intake and referral for APS. She then spoke about changes and how they may be implemented in Bayfield County using the new guidelines. However, Watters- Moffit reported that how changes are implemented may be directed by the state. • A tiered assessment system will differentiate between cases that represent immediate risk from others. The current required response times for immediate risk cases commence within 24 hours (excluding weekends and legal holidays) of receiving a report. The new rule will require an in- person response within 24 hours and will require an APS worker, a law enforcement, or another appropriate community responder to make contact. Lower to moderate risk response time is now seven days. • APS programs must provide at least two ways that a report can be made 24 hours a day, seven days a week. At least one way to file a report must be electronic and available on-line. Bayfield County currently lists the Department phone number on the website and individuals can phone the Department to speak to staff or leave a voice mail message. During business hours, callers are FINAL: Approved at the 6/27/24 DHS Board meeting. BAYFIELD COUNTY HUMAN SERVICES BOARD MEETING EOC & Virtual May 23, 2024 K:\Agendas and Minutes\DHS Board\Minutes\2024 DHS Board Minutes\2024-05-23_BCDHS_Board_meeting_minutes -FINAL.docx 2 transferred to the Aging & Disability Unit. After hours, reporters can leave a message or call law enforcement. • Discussions about a portal for reporting as an online option are being discussed. • Rules also require APS systems to ensure that planning and delivery respect the fundamental rights of competent adults to make their own choices and accept or reject services based on their needs and preferences. Rights must be provided immediately to ensure individuals know and understand their rights at the beginning of an investigation. Schmidt asked if Bayfield County already performs some or most of what is required by the new plan. Linder noted that Bayfield County is meeting the current statutory guidelines. Rekemeyer asked how many APS reports were filed last year. Watters-Moffitt reported that there were seventy-one reports in 2023. Rekemeyer asked who makes referrals to the Department. Watters-Moffitt replied referrals are received primarily from hospitals, clinics, social workers, neighbors, family members, and law enforcement. Watters-Moffitt noted it is rare for someone to call for themselves. Crandall asked how many reports are not valid. Watters-Moffit noted there are different categories, substantiated, not substantiated and unable to substantiate. Once the Department receives a report, an investigation is conducted to identify evidence, build rapport, assess risk, and determine the individual’s capacity. Some investigations end when the person indicates they do not want services. If people are competent or not incapacitated, they have that option. The new federal rule requires APS to establish a timeline that is well documented. There must be coordination and consultation with a supervisor to ensure investigations are performed properly, and to avoid civil rights violations. If an individual is not interested in receiving services, staff provide them with information regarding the resources available and ask them to reach out in the future if they change their mind. Rosa asked if there is opposition. Watters-Moffitt reported that there is generally no conflict or opposition. Many individuals will politely thank the APS worker for the information but indicate they are not interested in receiving services. Watters-Moffitt said staff might offer to assist an individual to enroll in the home delivered meal program. Watters-Moffitt and Karen Bodin work with the Aging Services Supervisor to enroll individuals who are interested. Then the drivers have regular contact with the individual. Since drivers see participants several times a week, they are often able to recognize and report any changes in the individual’s circumstances or condition. Crandall asked about the ages served. Watters-Moffit stated they serve vulnerable adults between the ages of 18 and 59, and elder abuse to individual who are age 60 or older. Irvine questioned if individuals are ever afraid that they will be removed from their home. Watters- Moffitt replied yes, but that they explain that staff will always try to help individuals remain in their homes with services whenever possible. If an individual has not been deemed incapacitated, they have the right to live however they want, so receiving services is voluntary. Crandall asked where people are referred. Individuals are referred to ADRC for options counseling to help determine what resources are available to best meet their needs. Some are referred to other BAYFIELD COUNTY HUMAN SERVICES BOARD MEETING EOC & Virtual May 23, 2024 K:\Agendas and Minutes\DHS Board\Minutes\2024 DHS Board Minutes\2024-05-23_BCDHS_Board_meeting_minutes -FINAL.docx 3 human services departments or non-profit organizations. Croteau also stated the New Day Advocacy wraparound services can mitigate situations where domestic violence might be a contributing factor. Rekemeyer asked about wards of the state. Linder explained there is extensive process in Wisconsin as wards of the state refer to people under guardianship, who have been found incompetent by the court. Linder reported that World Elder Abuse Awareness Day is June 15, 2024. To celebrate the event, a Senior Empowerment Day, in Iron River will be held on June 14, 2024. The event will include speakers, a light lunch, and brain health/memory screens. Monthly Section Reports Behavioral Health and Community Programs – Tom Croteau • Croteau reviewed historical enrollment date for the CCS. There are currently 49 participants. • CCS remains understaffed as the program continues to grow. DHS continues to recruit for a Mental Health Professional. The position has been posted since the end of 2023. • Croteau is looking for other immediate options to address the workload. Richard Carbon, CCS intern, is working to index and upload old CCS files into the new electronic health record, Echo, which helps save staff time. Croteau also noted Behavioral Health staff provide continuity of care with clients they have already built rapport and assist them transition into the CCS when a referral is made. • The Community Support Program (CSP) serve individuals with severe and pervasive mental illness. Croteau notes that the CSP program can help participants avoid hospitalization through frequent client contact and services. Current enrollment is. There is one more referral that will be accepted in June. • Behavioral Health staff remains steady. Hailey BeBeau just celebrated a one-year anniversary and Jamie Allen will soon be celebrating her second anniversary. Continuity of staff helps to create a better workflow and provides more stability for participants. • Emergency detentions (ED) numbers continue to ebb and flow. Croteau noted there were a couple of back-to-back detentions processed in the last few weeks, including one from out of state. Croteau states that these referrals generally come from law enforcement and hospital systems. • Rosa questioned the difference between CSP, CCS and Behavioral Health. Croteau noted CSP is provided to individuals with chronic and pervasive mental health issues who need a lot of support to remain in the community. Behavioral Health is primarily focused on people who are receiving court ordered involuntary services or and/are experiencing a mental health emergency. CCS is a voluntary psychosocial community based rehabilitative program for eligible residents. It focuses on helping people who have a mental health and/or substance abuse diagnosis on their journey to recovery. Economic Support Services – Jeanine Spuhler • Spuhler noted that Bayfield County participants eligible for Medicaid received $33 million in health care services in 2023. BAYFIELD COUNTY HUMAN SERVICES BOARD MEETING EOC & Virtual May 23, 2024 K:\Agendas and Minutes\DHS Board\Minutes\2024 DHS Board Minutes\2024-05-23_BCDHS_Board_meeting_minutes -FINAL.docx 4 • Last week was Economic Support appreciation week. Spuhler stated staff were recognized by their supervisors and the Consortium Administrator. The Northern Income Maintenance Consortium (NIMC) staff serve approximately 65,000 people in the northern region. • Spuhler said the summer fill program will be offered again in 2024. The guidelines this year are more restrictive than in 2023. Staff have been working on distributing funds to participants. • Staff will be trained on how to determine eligibility for the Wisconsin Home Energy Assistance Program (WHEAP) air conditioning program next week. • Spuhler noted that the regular heating season closed on May 15, 2024. Emergency assistance is still available. • Unwinding policies end as of June 30, 2024. After June 30th, all standard income maintenance policies and procedures will apply. • Spuhler is happy to welcome Colleen Detjens to the Economic Support team. Spuhler reported training is going well and Detjens is a great fit for the team. Family Services – Elizabeth Skulan (for Mary Anich) • The bi-annual review for childcare certification will take place in July. • Anich attended several childcare certification program meetings with the state, both remotely and in-person at the Northwest Connection Family Resources office in Hayward on May 22, 2024. Every county and tribe certify and regulates in-home childcare providers who care for three or less children aged 0-7 who are unrelated to the caregiver. Many counties contract with Northwest Connection to provide the certification as the tasks are infrequent for a small county like Bayfield, and it is fairly time intensive to keep up with all the required duties to keep the program compliant. Unfortunately, neither Bayfield County nor the Red Cliff Tribe currently have any certified homes, and no one has recently expressed an interest in being certified. Recruiting for this essential job is very difficult due to the state requirements of providers. Ashland County currently has providers, but those numbers have also dwindled from twenty providers down to nine in the last few years. Anich noted that the area is resource poor regarding childcare. • The Coordinated Services Team (CST) program will serve youth with significant emotional disturbances that are involved in two or more systems of care. Anich, Skulan, and CST Coordinator Live Garramone attended a meeting with White Pine Consultants on May 10, 2024. Bayfield County is looking for assistance in creating policies and procedures for the CST program. Skulan has also reached out to Ashland County for information on their CST program guidelines. • Anich and the youth justice case managers attended a meeting with the State regarding the Interstate Compact for Juveniles on May 17, 2024. Anich noted the Interstate Compact refers to the states follow when a juvenile who is on supervision in another state relocates, is placed, or requests to be placed in Wisconsin or Bayfield County. • Anich participated in an interview for the Family Services Specialist position. Anich stated the position has not yet been filled. • Anich noted that Family Service work continues to be challenging and the number of new cases continues to increase. • Rosa posed a question from a constituent about truancy policy. Anich updated the board on the process. Support Services – Elizabeth Skulan (for Stephanie Eder) BAYFIELD COUNTY HUMAN SERVICES BOARD MEETING EOC & Virtual May 23, 2024 K:\Agendas and Minutes\DHS Board\Minutes\2024 DHS Board Minutes\2024-05-23_BCDHS_Board_meeting_minutes -FINAL.docx 5 • Skulan noted that Eder and the financial team are preparing for the 2023 single audit. • Data is being prepared for managers for the DHS 2023 Annual Report. • Skulan, Eder and the financial team are beginning work on budget and identifying priorities for 2025. Aging & Disability Services – Carrie Linder • Linder attended several meetings including trauma informed care service training to alleviate burnout. • Linder noted Bayfield County was awarded a vaccination grant, a collaboration between DHS and the Public Health Department. Linder increased the grant request to $204,000 to include equipment, billboards, video productions, social media, and other outreach. The grant brings vaccinations to the elderly into their communities. The final contract has not yet been issued. • The social isolation grant was also awarded, but not for the entire amount requested. Linder is developing a request for proposal for a facilitator to perform the work identified in the grant. • Linder attended Aging Advocacy Day at the capital. • Chartwells notified Bayfield County they are still in negotiations with Northland College to provide their food service after June 15, 2024. If negotiations are unsuccessful, Chartwells may not provide home delivered meals after June 15, 2024. If that is the case, the Bayfield County Kitchen may provide the additional meals. However, they are currently understaffed. Carolyn Novak is working Plan B, which would include securing prepackaged meals that can be used during a transition from Chartwells. • StrongBodies exercise program starts on June 11, 2024, in Port Wing. • A total of 259 responses were submitted to the Aging Plan Survey. Results will be compiled by a Public Health intern. • Linder and Novak met with their counterpart Sarah Tourdot from Red Cliff to improve collaboration. Monthly Reports Monthly Financial and Training reports were reviewed and retained. Discussion and Possible Action – Recommendation to support the request for a new CCS Service Facilitator position in the 2025 DHS budget. Due to projected increases in the Comprehensive Community Services enrollment in 2025, the Department requested Board support to include another fully funded CCS Service Facilitator position in the 2025 budget. Motion by Milanowski, seconded by Rekemeyer, to support request for a new CCS Service Facilitator position in the 2025 DHS Budget. Motion passed. Discussion and Possible Action – Review and consideration for approval of reappointment of Beverly Patterson to Family Services and Behavioral Health Advisory Committee retroactive to July 2023. BAYFIELD COUNTY HUMAN SERVICES BOARD MEETING EOC & Virtual May 23, 2024 K:\Agendas and Minutes\DHS Board\Minutes\2024 DHS Board Minutes\2024-05-23_BCDHS_Board_meeting_minutes -FINAL.docx 6 Patterson indicated interest in continuing to serve as a member of the Family Services/Behavioral Health Advisory Committee. The committee recommended her appointment retroactive to July 2023. Motion by Schmidt, seconded by Irvine, for approval of the reappointment of Beverly Patterson to Family Services and Behavioral Advisory Committee retroactive to 2023. Motion passed. Discussion and Possible Action – Review and consideration for approval, updated Emergency Detention Policy. The policies and procedure were updated to reflect the current process with Northland Counseling. Motion by Milanowski, seconded by Rekemeyer, to approve updated Emergency Detention Policy. Motion passed. Discussion and Possible Action – Review and consideration for approval, updated Consumer Repayment Policy (formerly Collections Repayment Policy). The draft policy update was provided to the board with modifications. The modifications were reviewed. The policy changes reflect current practice. Defoe-Haskins voiced her disagreement with the policy. Skulan noted the policy has been in place and that these modifications were clarifications, rather than changes, to the original policy. Motion by Rosa, seconded by Schmidt, to approve updated Consumer Repayment Policy. Defoe- Haskins opposed. By 7-1 vote, motion passed. 2025 Budget Planning – Review Documents 2025 Budget Planning documents were reviewed. A public hearing will be held during the June meeting. Other (Informational Items) • Economic Support Specialist and Case Manager’s Week Proclamation. • Tribal High Cost Pool Award. • ARPA HCBS Social Isolation and Loneliness Grant Award. • May 7, 2024, email from Steve Budnik, Northern Income Maintenance Consortium regarding Economic Support Specialist Jessica Soulier. • Dougherty reported that the Tribes may develop the Pigeon Lake property to establish a Wellness and Treatment Center for Youth. Future Meetings • The June meeting will be held on June 27, 2024, in the County Board Room. The meeting will include the Public Hearing on the 2025 Budget and an Opportunity for Comments Regarding Bayfield County’s Policies and Procedures for Equal Opportunity in Employment, Service Delivery and Language Access. BAYFIELD COUNTY HUMAN SERVICES BOARD MEETING EOC & Virtual May 23, 2024 K:\Agendas and Minutes\DHS Board\Minutes\2024 DHS Board Minutes\2024-05-23_BCDHS_Board_meeting_minutes -FINAL.docx 7 • The July/August meeting will be held on August 15, 2024, in the County Board Room from 1:30 to 3:00. It was moved since space is not available due to construction and development of regional dispatch. It will be an abbreviated meeting since the room is only available until 3:00. • September 26, 2024 Crandall adjourned the meeting at 5:54 p.m. Submitted by Sarah Traaholt, Clerk III