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HomeMy WebLinkAboutHuman Services Board - Minutes - 9/25/2025BAYFIELD COUNTY HUMAN SERVICES BOARD MEETING EOC & Virtual September 25, 2025, 2025 K:\Agendas and Minutes\DHS Board\Minutes\2025 DHS Board Minutes\2025-09-25_BCDHS_Board_meeting_minutes -FINAL.docx 1 Board Members Present: Mary Dougherty, Teri Hanson, Jeff Holte*, Donna Lundin, Marty Milanowski, Amy Nigbor, Jeremy Oswald, Sue Rosa *virtual Board Members Absent: James Crandall Others Present: Tom Croteau, Stephanie Eder, JoBeth Gonzalez, Christopher O’Dell, Jeanine Spuhler, Brynna Watters- Moffitt, Hayley Weyers, Call to Order and Introductions Milanowski called the meeting to order at 4:00 p.m. Introductions were made. Discussion and Possible Action – Review and approval of the August 12, 2025, meeting minutes. Motion by Rosa, seconded by Hanson, to approve August 12, 2025, meeting minutes. All in favor. Motion passed. Program Presentation – Federal Budget Reconciliation act (H.R.1) changes to Medicaid and FoodShare Eligibility Rules. - Jeanine Spuhler, Economic Support Section Manager  Spuhler spoke to the committee, discussing additional details about the cost to Wisconsin taxpayers of implementing the federal reconciliation bill and timing for when the requirements will go into effect, released by the Wisconsin Department of Health Services.  Spuhler stated the goal of letting the Medicaid and FoodShare members know that currently, nothing has changed with their benefits, and program rules will not change without ample notification. Changes are going to be made, but we will work with members to deal with these changes as we become aware of them.  Spuhler stated the importance of making sure members keep their information up to date, and we will be using different contact methods to keep members abreast of any new rules and requirements.  The state will continue to provide updates to partners, providers and the public as we receive further guidance from the federal government about how to fully implement the policy changes.  Spuhler discussed the work requirements for BadgerCare Plus members ages 19 through 64 that do not have a child under age 19 living with them:  Many Wisconsinites work in jobs that don’t offer health insurance, and many others can’t work because of a health condition. A new Medicaid work requirement will mean these adults will have to report at least 80 hours per month of work, training, or volunteering.  Anticipated impact(s): Decrease in Medicaid coverage for people who miss paperwork deadlines or who are unable to meet the requirement Approved at 10/23/2025 DHS Board Meeting BAYFIELD COUNTY HUMAN SERVICES BOARD MEETING EOC & Virtual September 25, 2025, 2025 K:\Agendas and Minutes\DHS Board\Minutes\2025 DHS Board Minutes\2025-09-25_BCDHS_Board_meeting_minutes -FINAL.docx 2  Increased costs for Wisconsin to offer employment and training services, including implementing new systems, creating new correspondence, and augmenting staffing to support implementation  Projected timeline: Effective December 31, 2026  Current status: Awaiting federal guidance  Spuhler discussed the shortening of the eligibility period for retroactive coverage for new members of Medicaid:  Sometimes people who are uninsured do not realize they can qualify for Medicaid until they have a health emergency and need immediate, urgent care like when they go to a hospital emergency department for care or need care at a nursing home. If someone is uninsured, a financial counselor with the provider will often work with them to determine if they can qualify for Medicaid. When people sign up for Medicaid, they are able to receive retroactive coverage to pay for care they received if they met all Medicaid rules during that time. Under the new law, Medicaid members can only receive retroactive coverage for two months instead of three months.  Anticipated impact(s):  Fewer health care and nursing home costs being covered by Medicaid  More medical debt for uninsured or underinsured Wisconsinites  More costs being passed along to consumers by health care providers to make up for lost revenue  Projected timeline: Effective January 1, 2027  Current status: Awaiting federal guidance  Spuhler discussed the expansion of FoodShare work requirements:  Under the new law, the work requirement for FoodShare now applies to FoodShare members 18 through 64 if there is not a child under age 14 in their home.  Anticipated impact(s):  Decrease in FoodShare enrollment for vulnerable individuals and families who miss paperwork deadlines or who are unable to meet the requirement  Decrease in revenues for Wisconsin farmers, transportation vendors, and retail outlets where FoodShare benefits are used because fewer people will receive FoodShare benefits  Increased costs to rework systems and train staff to process and monitor an influx of documentation  Increased costs of $14.6 million for the FoodShare Employment and Training (FSET) Program  Projected timeline: Unknown  Current status: Awaiting federal guidance.  Spuhler discussed the possible federal government shift of Supplemental Nutrition Assistance Program (SNAP) benefit costs to Wisconsin: BAYFIELD COUNTY HUMAN SERVICES BOARD MEETING EOC & Virtual September 25, 2025, 2025 K:\Agendas and Minutes\DHS Board\Minutes\2025 DHS Board Minutes\2025-09-25_BCDHS_Board_meeting_minutes -FINAL.docx 3  Under the new law, if a state’s payment error rate is above 6%, the state will be required to pay 5-15% of SNAP benefit costs, depending on their error rate. Based on the most recent year of benefit cost data (state fiscal year 2025), if Wisconsin’s error rate was over 6%, this would cost Wisconsin taxpayers between $68.5 million and $205.5 million annually.  Spuhler discussed FoodShare Funding, stating that as of October 1, 2026, federal funding for FoodShare Administrative costs will shift to 25% instead of 50%. As of October 1, 2027, states must contribute to the cost of benefits if their QC error rate is above 6%. She further discussed error rates:  Achieving and maintaining Wisconsin’s historically low error rate while implementing other complicated provisions of the law will be challenging without additional state and county quality control staff. FoodShare quality control staff to review cases before they are confirmed to identify and address errors. States are able to eliminate errors and keep their error rates low if they identify and address errors before a case is confirmed. If states achieve and maintain an error rate below 6% over the long-term, they do not have to pay for benefit costs. The Department of Health Services will need up to $11.4 million annually to hire additional FoodShare quality control staff to review cases before they are confirmed to identify and address errors.  Anticipated impact(s): Increased costs of $11.4 million to hire additional quality control staff and make systems changes to achieve a low error rate long term  Projected timeline:  Increased benefits cost sharing effective October 1, 2027  Quality control investments needed October 1, 2025, when the 6% error rate threshold goes into effect.  Current status: Planning for this change  Spuhler discussed shifts in administrative costs from the federal government to Wisconsin:  Under the new law, the federal government will shift half of its share of administrative costs for running FoodShare to our state and counties, increasing Wisconsin’s share from 50% to 75%.  Anticipated impact(s):  Increased costs of $43.5 million each year with anticipated increases over time.  Projected timeline: Effective October 1, 2026  Current status: Planning for this change  Spuhler stated the reconciliation package makes changes to SNAP that would reduce federal financial participation and significantly impact county administered services. These cuts result from shifting the benefit and administrative costs to states and counties, tightening work requirements and penalizing minor payment errors.  Oswald asked how the error rate was determined. Spuhler responded that the state and federal government pulls cases and checks their accuracy. BAYFIELD COUNTY HUMAN SERVICES BOARD MEETING EOC & Virtual September 25, 2025, 2025 K:\Agendas and Minutes\DHS Board\Minutes\2025 DHS Board Minutes\2025-09-25_BCDHS_Board_meeting_minutes -FINAL.docx 4  Croteau asked what Bayfield County’s current error rate was. Spuhler responded that it was around 3%.  Eder asked what defines an “error.” Spuhler responded and provided the examples of timeliness, accuracy of information and accuracy of benefit amounts.  Rosa asked what the state-wide error rate was. Spuhler responded that it is 6.5%.  Croteau stated the increase to Bayfield County will be $160,000 per year to maintain the Northern Income Maintenance Consortium (NIMC).  Dougherty asked if losing coverage through ACA was part of Economic Support. Spuhler responded that she was not aware of that occurring but mentioned if someone is not eligible for BadgerCare Plus, they cannot get coverage through ACA.  Spuhler stated that it is important for members to make sure their contact information is kept up to date so they can be provided with the most recent developments.  Spuhler stated there have been fewer calls from people who do not speak English or are not US citizens, which can affect entire families.  Oswald asked who determines if members meet the work requirements. Spuhler responded that the people who handle the FSET program will do that, it will not be the responsibility of NIMC.  Rosa asked if there were any issues with immigration police in the area. Croteau responded that there have been social media posts about ICE being in Washburn. Monthly Section Reports Behavioral Health and Community Programs (BHCP) – Tom Croteau  Croteau stated there were no new section manager applicants.  Croteau stated there were some challenges with emergency detentions (ED) and discussed the different types of ED.  Gonzalez asked if those who were subjected to ED were offered voluntary services. Croteau responded they are offered, but often they aren’t in the proper state of mind to make those decisions.  Rosa asked how the department works with law enforcement. Croteau responded that AVEL is available to law enforcement if Bayfield County is not already involved. AVEL helps law enforcement make assessments which allows Bayfield County to step in if needed or requested.  Hanson asked if a Bayfield County staff member travels to the facilities with law enforcement. Croteau responded that they do not, but sometimes secure transport is needed and used.  Croteau stated overall costs for CCS are in line with expectations. Direct Services and Contracts Services are over budget, which will require an amendment next month.  Croteau stated there have been some challenging situations that have required him to step in to provide guidance to the team.  Dougherty asked if there had been discussions with employees about the potential for violence in certain situations, what steps are being taken and if employees can state safety concerns. Croteau responded that there have been discussions with staff to ensure their safety. If they have concerns, they are encouraged to travel in pairs. Croteau and Gonzalez feel their staff have a good feel for certain situations and determine the best way to handle it and are empowered to BAYFIELD COUNTY HUMAN SERVICES BOARD MEETING EOC & Virtual September 25, 2025, 2025 K:\Agendas and Minutes\DHS Board\Minutes\2025 DHS Board Minutes\2025-09-25_BCDHS_Board_meeting_minutes -FINAL.docx 5 make the best decisions. Eder added staff includes addresses for where they are going on the calendar, so staff knows where they are and when they should return.  Croteau stated that Alan Spaude-Filipczak, our Mental Health Professional, is interested in going to work full-time next year, but the department would benefit from that happening sooner rather than later. Family Services (FS) – Jo Beth Gonzalez  Becky Benton was hired as the Youth Justice Case Manager on September 2, which fully staffed Family Services! Benton previously worked with Red Cliff. She’s eager to start with a caseload but is still in training for a couple months.  One of the LTE contracts ended in August, and another will end in November.  Gonzalez, Benton, Brittany Anderson and district attorney Kim Lawton attended the Wisconsin Juvenile Court Intake Association (WJCIA) conference in Wisconsin Dells. Gonzalez stated it was a good conference with good discussions and team building and collaboration with the District Attorney’s office.  Gonzalez stated Keldi Merton and Melissa Berthiaume are attending the Child Welfare & the Courts conference in Wisconsin Dells. Merton and Berthiaume are the primary CPS workers, and this conference will be helpful for their practice and case work.  Gonzalez stated she will be participating in discussions with Judge Anderson related to Juvenile Justice Restorative Practice.  Gonzalez stated they will be picking back up discussions with Anderson, Lawton and community schools to discuss truancy, which is a hot topic at the present time.  Gonzalez stated youth justice intakes and referrals for delinquent acts have continued to be steady.  Gonzalez stated several of our high-cost placements ended in August. A program called 180 is being considered for one of them. A high-level mental health/behavioral health placement will end in October due to the end of the delinquency order and the youth aging out. We are looking for ways to assist them when this happens. Two youths may be moving soon for a better out-of- home placement that will meet their long-term needs.  Gonzalez stated she appreciates all the work her staff does and is excited about what the future holds.  Gonzalez stated CLTS/B-3 continues to have consistent enrollment, and the staff is working to implement and carry out the service plans.  Rosa asked how it is anticipated that placements will end by a certain date. Gonzalez responded that working closely with providers to understand how things are going gives them a better idea of a possible discharge date. Croteau added that sometimes there is also a legal end date, whether it be mandated by a court or by age. Aging and Disability Services (A&D) – Brynna Watters-Moffitt  Watters-Moffitt announced that the Bayfield County Home Delivered Meals program was awarded the 100 Who Care top prize of $11,800. She stated it will be used to provide stable shelf food and meals to people during the winter months and provide warming kits in case of power outage or lack of heat due to energy assistance cuts. BAYFIELD COUNTY HUMAN SERVICES BOARD MEETING EOC & Virtual September 25, 2025, 2025 K:\Agendas and Minutes\DHS Board\Minutes\2025 DHS Board Minutes\2025-09-25_BCDHS_Board_meeting_minutes -FINAL.docx 6  Carolyn Novak and Gina Park are attending trainings in Hayward for Health Living with Diabetes. We are hoping to provide a workshop throughout the county once they have been trained. This program has been shown to reduce the need for medical intervention due to diabetes through education.  Madi Mackin is busy with the TAP program. The number of calls is overwhelming. There are many calls for people who need rides but not a lot of drivers. Some people must be turned down due to that lack.  Michele Reiswig and Alex Erickson are busy with guardianships and protective placements. Watters-Moffitt stated there has been an uptick in the last 4-6 weeks.  Watters-Moffitt and Erickson attended a fourth tribal meeting in Black River Falls. The meeting brought tribes and counties together to talk about how to improve and what is working. Watters-Moffitt stated Red Cliff is hoping to get an APS worker, and Bayfield County is helping.  Lindi Olson and Ann Marie Mackin continue to be busy.  Marianne Johnson is preparing for her busy time of year with Medicaid Open Enrollment occurring 10/15/25-12/7/25. Last year she helped over 200 people.  Jamie Mackin is still busy with a caseload of over 130. He has been covering Price County. They have hired someone who should lighten the load.  Milanowski asked how the changes to home delivered meals were going. Watters-Moffitt responded that things are going well. There has been an increase in sign-ups, and the food has been well received.  Rosa asked if we anticipate needing more staff. Watters-Moffitt responded that she does not believe that is necessary at this point. There is always an ebb and flow with cases, but time will tell. Support Services (SS) – Stephanie Eder  Eder stated Support Services is fully staffed.  Staff are preparing for Kathy Wolfram-Moran’s retirement, which consists of cross-training.  Staff are preparing to transition to Adult Long-Term Care billing to Wisconsin Medicaid for Forward Health beginning January 2026. Economic Support Services Section Manager – Jeanine Spuhler  Spuhler stated that there is nothing new to report about energy assistance or LIHEAP funding. In the meantime, they are continuing to take applications and doing outreach.  Currently furnace referrals are not allowed. Air conditioning referrals are allowed only if heating system is also not working.  There is a reduction in eligible situations for the water conservation program.  With the county spending over $400,000 on energy assistance, there is some concern about funds for the upcoming winter. Dougherty suggested telling the Executive Committee the DHS board wants to fund propane clients in need. Milanowski suggested waiting until we know what LIHEAP funding will be. Spuhler stated that LIHEAP funding also pays employee wages. BAYFIELD COUNTY HUMAN SERVICES BOARD MEETING EOC & Virtual September 25, 2025, 2025 K:\Agendas and Minutes\DHS Board\Minutes\2025 DHS Board Minutes\2025-09-25_BCDHS_Board_meeting_minutes -FINAL.docx 7 Monthly Reports Monthly Financial and Overnight trainings were reviewed and retained. Discussion and Possible Action – Consideration of approval of DHS Resolution 2025-04 Department of Human Services- Impact to Bayfield County’s Children’s Community Options Program Allocation from Recommended Legislative Changes to the Maintenance of Effort for the Children’s Long-Term Support.  Weyers presented and discussed the resolution with the committee.  Dougherty commended Weyers on the resolution.  Oswald asked if it would carry more weight if the resolution went to the full board. Dougherty stated it should go to them.  Dougherty suggested the resolution is sent to the WI Counties Association. Motion by Dougherty, seconded by Rosa, to accept DHS Resolution 2025-04 and recommend approval by the full board. All in favor. Motion passed. Discussion and Possible Action – Consider proposed recommendation to appoint Todd Mattson to the Transportation Coordinating Committee (TCC)  Croteau presented Todd Mattson’s application. Motion by Rosa, seconded by Nigbor, to accept the appointment of Todd Mattson to the TCC. All in favor. Motion passed. Discussion – Human Services risk reserve  Croteau opened the discussion by referencing the narrative presented to all members:  The cost of mandated services for high-cost placements can vary significantly and, at times, be extremely expensive. A single out-of-home placement can easily exceed $300,000. Looking ahead to 2027, the annual cost for one youth placed at Lincoln Hills or Copper Lake is projected to reach nearly $1 million—more than double the current rate. In 2024, out-of-home placement expenses were as follows:  Youth Residential Care: $537,177  Non-Youth Aids Foster Care: $453,137  Mental Health Institutions: $576,950  Mental Health Inpatient: $70,507  Total: $1,637,771  Reimbursements: -$448,000  Final Cost: $1,189,771 As of the end of August 2025, expenses are already $241,437 over budget. The current risk reserve stands at $635,000. To balance the 2024 budget, which is projected to exceed budgeted costs by $111,862, we will need to draw from this reserve. The last time the risk reserve was used was in 2017, when $91,895 was required to cover similar expenses. Since then, on average, we’ve returned approximately $620,400 annually to the general fund from our $1.8 million county levy budget. BAYFIELD COUNTY HUMAN SERVICES BOARD MEETING EOC & Virtual September 25, 2025, 2025 K:\Agendas and Minutes\DHS Board\Minutes\2025 DHS Board Minutes\2025-09-25_BCDHS_Board_meeting_minutes -FINAL.docx 8 This discussion is driven by the need to strike a balance between years when we must rely on the risk reserve and years when we are able to return funds. Given that costs are steadily rising—and may eventually outpace the current reserve—it’s important to plan ahead. However, we also want to ensure we’re not overfunding the reserve unnecessarily in low-expense years. A proposed approach includes:  Minimum Risk Reserve: $650,000  Maximum Risk Reserve: $1 million  A percentage (e.g., 10%, 20%, or more) of any year-end carryover would be allocated to the reserve until the maximum is reached.  If the reserve falls below the minimum, DHS would request funds to restore it to at least the $650,000 threshold. This strategy allows for a gradual increase in the reserve without requiring a large, one- time commitment. It also provides a more flexible and sustainable method to replenish the fund following years of high-cost placements.  After much discussion it was agreed to request the maximum risk reserve amount.  Croteau stated he would speak to Mark Abeles-Allison about the next steps for this process. Future Meetings  October 23, 2025  December 2, 2025 (November/December meeting, begins with potluck at 3:30) Dougherty adjourned the meeting at 5:33 p.m. Submitted by Christopher L. O’Dell, Clerk III