AGENDA
Public Health and Human Services Board
8:30 AM - Tuesday, June 19, 2018Commissioners Board Room
Page 1. CALL TO ORDER
2. APPROVAL OF CONSENT AGENDA Motion to approve as a whole
A. Meeting Agenda B. May 2018 Minutes
May 2018 Minutes
3 - 6
C. Abstracts and Bills
Abstracts and Bills June 2018
7
D.
Purchase of Service Contract between Cook County and Jacqueline
Sebastian for Family Group Decision Making
J. Sebastian Contract
9 - 14
3. STAFF REPORT
A. 2017 Year-End Financial Report – Lori Ericson, Fiscal Supervisor 2017 PHHS Financial Report
15
4. DIRECTORS REPORT A. Staff Updates B. Agency Updates 5. ITEMS FOR BOARD ACTION 6. COMMITTEE REPORTS
A. Arrowhead Economic Opportunity Agency - Myron Bursheim (Primary), Ginny Storlie (Alternate)
B. Arrowhead Health Alliance Joint Powers - Jan Siverston (Primary), Heidi Doo-Kirk (Alternate)
C. Arrowhead Regional Corrections - Robert Deschampe (Primary), Myron Bursheim (Alternate)
D. Arrowhead Regional Development Council - Ginnie Storilie E. Community Health Board - Heidi Doo-Kirk
F. Public Health and Human Services Advisory Committee - Carla LaPointe and Jerry Lilja
G. Health Care Planning Committee - Ginny Storlie (Primary), Jan Sivertson (Alternate)
PUBLIC HEALTH AND HUMAN SERVICES BOARD MINUTES
May 15th, 2018
The Human Services Board met in regular session on the 15th day of May in the Commissioner’s Room of
the Cook County Courthouse in Grand Marais, MN. Public Health and Human Services Board Chair Heidi Doo-Kirk called the meeting to order at 8:30 am.
Commissioner Sivertson made a motion to approve the April consent agenda, seconded by Commissioner Storlie and approved all ayes.
2018 First quarter Financial Report- Lori Ericson
Ericson explained that expenses for the final quarter of last year are paid in the first quarter of the following year. Ericson reported on areas that are under budget, such as childcare, mental health, and employment and training. Like expenses, much of the revenue coming in the first quarter of the year, is actually generated in the final quarter of the prior year. Ericson did mention that for expenditures, that the administrative area is higher than last year, due to the fact that a position was added later in 2017. The Board thanked Ericson for her report.
Disability Services Innovation Grant Staff Report – Julie Kinney, Social Worker and Martina Williams, Adult and Home & Community Based Services Supervisor
Williams introduced Melissa Oberg, Special Education Teacher at ISD 166, and student, Kyle Nelson to the board. Williams then gave some background on the Olmsted act and the Jensen Settlement. One of the of the agreements of the Jensen Settlement was that the state would develop an Olmstead plan. The goal of the plan is to make Minnesota a place where people with disabilities can live their lives in the most integrated setting, to ensure that Minnesotans have choices, and to make sure that planning is person centered. Another
legislative requirement is the Workforce Integration Act, which limits the use of subminimum wages. Williams explained that in the past, people living with disabilities made subminimum wages. This also mandates the county social workers to explore competitive integrated jobs. DHS is expecting that within the year, the agency will assist at least 2 people in gaining competitive employment, and 15 people within five years. Williams explained that up until now, we have not had employment services available to this population. Kinney spoke of limited resources in the county, and how many were forced to move out of county in order to receive services. Williams stated that she wanted to figure out a way to bring these services to Cook County.
Williams shared that Melissa Oberg works at ISD 166, and works with students in the 18-21 program that focuses on job and transition skills. The role of carving out jobs for the participants was falling to Oberg and Kinney. This left a gap in services, and the nearest workforce center is located in Duluth. There is one Vocational Rehabilitation worker that services our county. He visits about once every 6 weeks. When information on the grant was released a team had come together that consisted of ISD 166, HDC, and Cook
MEMBERS PRESENT: STAFF PRESENT: ABSENT:
Virginia Storlie Heidi Doo-Kirk Myron Bursheim Jan Sivertson Robert Deschampe Carla LaPointe Jerry Lilja
Alison McIntyre, PHHS Director
Sara Hadley, Executive Administrative Assistant Jeff Cadwell, County Administrator
Martina Williams, Home and Community Based Services Supervisor
Julie Kinney, Social Worker Lori Ericson, Fiscal Supervisor
County PHHS. HDC already has an employment connection program. Williams stated that the team met and submitted the grant request in June of 2017. The grant monies would be uses for improving employment services, reducing barriers, and hiring a part time employment specialist through HDC. This person will help people living with disabilities to learn skills and obtain employment, and co-facilitate a support group. The outcomes would be to provide participants with an assessment, skills training, monthly support group for participants and families, and to carve out employment opportunism with the employers in Cook County. Williams stated that DHS is requiring us to have measurable goals.
Nelson talked about the way he is working now. He currently works for free, but this program will help him to be able to make money and work in the community. He shared that he was very excited to be here, and excited to see what opportunities this may bring for him. Williams stated that right now eight individuals have been identified as possible participants of the new program. Tom Sullivan has been hired in the
Supported Employment Specialist position, but will be reposted in the Fall as Sullivan works at ISD-166 as a paraprofessional.
Commissioner Bursheim thanked everyone for their hard work on this project, and thanked Nelson for coming and for all the work he does. Commissioner Doo-Kirk and Commissioner Deschampe shared stories about their family members living with disabilities, and thanked the group for all of their work, and
presentation.
Directors Report
McIntyre shared that James Zimmer, the new Adult Mental Health Social worker began his distance learning orientation this month. He will be in Cook County in June, and will start full time on June 11th. The Fiscal
Officer position was reposted. The Adult Services Social Worker position is open until filled, and Beth is retiring in September. The Public Health Nurse position is still open, but we have not been actively recruiting for this position. McIntyre stated that she had been meeting with Joni Kristensen, and they have been doing some strategic planning for Public Health services. She added that they are having conversations with Sawtooth Mountain Clinic about the potential to increase the Public Health services that they provide through a contract agreement with PHHS. The clinic is currently providing many maternal and child health services including WIC, Child and Teen Check-Up and there is great cohesion with these and primary care and perinatal services. Another strength is that the clinic has greater capacity for staffing more than one nurse. For PHHS to fully implement the Family Connects Family Home Visiting Program, there has to be two registered nurses on staff. We are still committed to providing these services, and the agency is looking at options as to what the possibilities are. Another area identified is the strengthening of our Emergency Response Team. PHHS has a responsibility to respond in an emergency, to set up shelters, check people in, dispense medications etc. Kristensen led the management team in an emergency preparedness exercise. It was a great exercise, and it helped us to identify training and other needs.
McIntyre shared that the Community Health Assessment stakeholder group is meeting in June. McIntyre stated that it is the last week of the legislative session, and there is a lot going on. One of the proposals is an opioid stewardship bill, which creates fees for opioid manufacturers. These funds would help to establish an opioid council, and part of the money will go to social services agencies for child protection, and families living with opioid crisis. Another issue is that some children’s mental health facilities will no longer be eligible for federal funding. Without further actions, counties would be solely responsible for 100% of the funding for children in placement. This would have significant impact on counties. McIntyre also shared that the state released a fiscal impact note last week on the MA work requirement proposal. The legislation would require MA enrollees to participate in work, or a training program. If these requirements are implemented, The Minnesota Management and Budget estimates the local impact would be $120 million to county agencies. Governor Dayton has indicated he would veto this bill.
McIntyre shared that the senate bonding bill contains 80 million dollars in capital investments for crisis care for people with behavioral needs and supported housing. The agency is continuing to recognize mental health awareness. 1 in 4 people have experienced mental illness in their lives. Commissioner Doo-Kirk stated that mental illness is something we need to talk with each other about to make it comfortable. McIntyre
shared that the www.makeitok.org website has some great resources for having conversation and working to break the stigma of mental illness. Commissioner Bursheim stated that there was a presentation of Let’s Talk at the Duluth YMCA, and there were thoughts about bringing some of these issues to our local YMCA.
Items for Board Action
Commissioner Bursheim made a motion to appoint Jodi Roberts to Cook County Public Health and Human Services Advisory Committee, seconded by Jerry Lilja. All ayes, motion passes.
Carla LaPointe made a motion to appoint Commissioner Doo-Kirk as alternate ex-officio member to Public Health and Human Services Advisory Committee (primary is Commissioner Sivertson), seconded by Commissioner Storlie. All ayes, motion passes.
Committee Reports
Arrowhead Economic Opportunity Agency Did not attend.
Arrowhead Health Alliance Joint Powers Did not meet.
Arrowhead Regional Corrections
Commissioner Deschampe reported that they had met and went over probation and client numbers. He commented that they have a large case load.
Community Health Board
Commissioner Doo-Kirk reported that she and Frances Jarchow of the PHHS Advisory Committee had taken a training.
Public Health & Human Services Advisory Committee
LaPointe shared that the North Shore Health Care Foundation is having a public meeting in the lower level of the clinic to discuss strategic planning. There was concern about how the MA recipients would have a work or volunteer requirement, and how it would affect Cook County residents. The agency felt that if this requirement that the committee would write a letter to legislators. Lilja shared that a sub-committee met to discuss community health grants, formerly discretionary funds. These funds go to entities in our county that promote health and wellness in the community. He added that letters to former applicants will be going out in June, and the due date for applications will be in July. The Advisory Committee will meet and come back to the Board with recommendations.
Healthcare Planning Committee
Commissioner Storlie reported that Kimber Wraalstad on hospital progression. There will be an open house this Thursday. She added that there was a general discussion about having trainings and speakers recorded and making them available to listening or watching.
North Shore Collaborative Did not meet.
Emergency Preparedness Committee
Commissioner Bursheim had attended a conference a few weeks ago, and he stated it was very worthwhile. He stated that he had attended a psychological first aid and incident command conference. He commended the emergency preparedness team for their work.
Commissioner Doo-Kirk adjourned the meeting at 9:33am.
The next Public Health and Human Services Board meeting will be held on June 19th, commencing at 8:30 AM.
Cook County
Public
Health and Human Services Board June19"‘
,
2018Section C: Abstracts: BE ITRESOLVED, that the Abstracts datedfrom May 16*‘,2018
to June
13”‘
, 2018 have been broughttothe attentionofthe Board andare approvedasWritten.Put to a vote, the motionwas ~90-/M1at. with
ayesand nays.
Section D: Bills: BE IT RESOLVED, that the foregoing isatrue andaccurate recordingofthe
of?cial actions and recommendations of the CookCounty Public Health andHuman Services
Board andassuchconstitutes theofficial minutesthereof. Present forpayment approval arethe Public Health andHuman Services Claims of$46,198.88
.
Presentedforapprovalarethe paid Public Health and Human Services Claims of$ 23 210.74
(Seeattachedsummary.) These have beenbrought tothe attentionofthe
Board
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Vendor: Jacqulin Sebastian Mediation/Consulting P.O. Box239 Knife River, MN 55609
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Cook County Public Health and Human Services Purchase of Services Contract
January 1,2018 to December 31, 2018
THIS AGREEMENT, by and betweenCOOK COUNTY HUMAN SERVICES BOARD, 411 W.
2"“Street Courthouse, Grand Marais, Minnesota 55604(hereinafterreferredto as“County”), and,
Jacqulin Sebastian, Mediation/Consulting, P.O.Box 239, Knife River, MN 55609(hereinafter
referredto as“Provider”),for the period of January 1,2018 to December 30,2018.
WITNESSETH:
WHEREAS, Provider represents that she has completedtraining and is duly quali?ed and willing to
perform FamilyGroupDecisionMaking (FGDM); and
WHEREAS, County wishestopurchase such servicesfrom Provider;
NOW THEREFORE, in considerationof the mutual understandings and agreements set forth, the
County and Provideragreeas follows:
Article I -- Purchased Services and Service De?nition
County agrees to purchase and Provider agrees to furnish Family Group Decision Making
(FGDM) services including; Facilitation Preparation
Facilitation explanationtoparticipants Negotiating meeting time
Facilitate Alternative Dispute Resolution meeting
Submit a?nal report
Article II —
Cost
and Delivery of Purchased ServicesA. B.
County shall pay Provider $500 per referral for facilitation of Family Group Decision
Makingprocesses. Itis anticipated theprocess shallnot exceed10hoursper referral.
County shall reimburse Provider $50/hour forreferrals that requiremore than10Facilitations
that requiremore thanten (10) hours of service.
Provider will be paid a minimum of 2hours at $50 an hour by theCounty if the referral is cancelled by theCounty andProvider has alreadybeguntheFGDM process.
E. The County shallpaythe provider$100.00 travelexpense toGrand Maraisor GrandPortage.
F. Provider shall be responsible for own costs and expenses including but not limited to
telephone, of?ce space and supplies. Thiscontract shallnot exceed$5,000.
Article III — Payment Process
A. Provider shall, within (10)working days,following the last dayofeach month, submita
standard invoice acceptableto County, indicating/containing:
l. Thebilling month;
2. Billable activityforthat month
3. Anapprovedsignature; and
4. Date ofsignature.
A. The invoice submittedtoCounty shall only includebillings fortheFGDM authorized by
County.
C. Methodof Payment
1. Upon approvalby the Social Services Supervisor,or Human Services Director, County
shall, within thirty (30)days from the dateofthe receipt of ‘theinvoice, makepayment toProviderforbillable hours authorizedby County.
2. County shall not be obligated to honor claims for nor shall Provider claim for any
services fumishedor costs incurredbyprovider, which are not speci?cally provided for
hereunderor requested byCounty in writingduringtheterm ofthisAgreement.
3. County’s obligationtomakepayment hereunderis subjectto audit byCounty or itsduly
authorizeddesignee andsaid audit shall be the ?nal determination ofCounty’s payment
obligation.
4. Provider will promptly reimburse County any payments received inexcess of required
payments hereunder.
Article IV -- Audit and Record Disclosure The Provider shall:
A. Send?nancial, statistical andprogress reports to County, asrequested.
B. Allow Personnel of County, the Minnesota Department of Human Services, the Minnesota
State Auditor’s Of?ce and the Department of Health and Human Services access to and
authority to copy Provider’s records at reasonable hours in order to exercise their right to
C. Maintain ?nancial records for ?ve years for audit purposes. Keep complete books and records according to generally accepted accounting principles, which shall fully document receiptsand expendituresofthepayments, received hereunder. Provider shall also keep such
book and records as are required by County to ful?ll County’s reporting responsibilities to
thestate andfederalgovernments.
Article V-- Safeguard of Client Information
A. The use or disclosure by any party or of any private information concerning a client in a
violation of any rule of con?dentiality or for any purpose not directly connected with the administrationoftheCounty’s or theProvider’s responsibility withrespect to the Purchased
Services is prohibited without the written consent of the client or responsible parent or
guardian.
B. Provideragrees to comply in allrespects with the MinnesotaGovernment Data Practices Act, Minn. Stat. Section 13.01-.48,and Provider furtheragrees to comply withany requests ofthe
County whicharenecessitatedbyCounty’s obligations under saidAct.
C. The parties agree to comply in all respects with the Health Insurance Portability and Accountability Act, Public Law 104-191 (HIPAA) and all rules, regulations and controls
affected or promulgatedpursuant thereto. The partiesagree thatasHIPAA and its rules and
interpretations become effective, the parties shall take whatever actions are necessary to
comply with HIPAA. Should a party fail or refuse to honor its obligationspursuant to the Section, the other party may give written notice of termination of this Agreement. Such
notice shall provide for termination of the contract within thirty (30) days of delivery of
notice and shall specify the actions, which are to be taken by the receiving party to meet
HIPAA requirements. The receiving party shall initiate required compliance with HIPAA
within thethirty(30)daysperiod in ordertoavoid terminationpursuant totheSection.
Article VI— Affirmative Action and Civil Rights Clause
Provider agrees to comply with the Civil Rights Act of 1964, Title VII (42 USCS 2000e),
including Executive Order No. 11246 as amended,titleV142 USC 2000d, theMinnesota Human Rights Act, and all applicable federal and state laws, rules, regulations and orders prohibiting discrimination in employment, facilities and services. Provider shall not discriminate in employment, facilities and in the rendering ofpurchased services hereunder onthe basisof race,
color, creed, religion, national origin, sex, marital status, public assistance status, disability, sexual orientation,or age.
Article VII -- Indemni? and Insurance Clause
A. INDEMNITY: Provider agrees to defend, indemnify, and hold County, its employees and
of?cials harmless from any claims, demands, actions or causes of action, including reasonable attorney’s fees and expenses arising out of any act or omission on the part of
provider, or its subcontractors, partners or independent contractors or any oftheir agents or
employees, in the perfonnance of or with relation to any of the work or services to be performedor fumished byProviderorthe subcontractors,partners or independentcontractors
or any oftheiragents or employees under thisAgreement.
B. INSURANCE: Provider acknowledges that there is no eligibility or coverage for the
County’sinsurance.
Article VIII -- Conditions of the Parties’ Obligations
A. Before the termination date speci?ed in this Agreement, County may evaluate the
performance ofProvider inregard totheterms ofthis Agreement to determine whether such
perfonnance merits renewalofthisAgreement.
B. Anyalterations, variations, modi?cationsor waivers ofprovisions of thisAgreement shall be valid only when they have beenreducedto writing, duly signed, and attachedtothe original
ofthisAgreement.
Article IX -- Subcontracting and Assignment
Provider shall not enter into any subcontracts or assignment of any of the work contemplated under thisAgreement.
Article X-- Independent Contractor
Provider isanindependent contractor andnot an employee oragent of theCounty. No statement
contained in thisAgreement shall beconstruedso as to?nd Providertobeanemployee oragent
of theCounty and Provider, its of?cers, employees andagents shall be entitledto none ofthe rights, privilegesor bene?tsof County employees. Nothing contained herein is intendednor shall be construed as inany manner creating or establishing an employment relationship between the
parties or as constituting Provider, its of?cers, employeesor agents astheagent, representative or
employeeof County for any purpose or inany manner, whatsoever. Article XI -- Cancellation, Default and Remedy
A. ThisAgreement shall continue in effect until terminated by eitherparty, withthirty(30) days
advance, written notice delivered to the otherparty, served on the Director, Cook County
Public Health & Human Services, 411 West
2"”
Street,Grand Marais, MN 55604-2307 onbehalfof County.
B. In the event of default by Provider, County may cancel this Agreement immediately by sending written notice of cancellation to Providerat its stated address, notwithstanding the provisions ofthe preceding paragraph. Thefailure ofProvider, to abideby any oftheterms,
conditions or requirements expressed in this Agreement shall constitute a default if not
corrected withinten (10)daysof receiptofwritten noticeof de?ciency fromCounty.
C. Provider agrees to notifycounty in writing withinten (10)dayswhenever Provider is unable
Upon such noti?cation, County shall determine whether such inability will require
modi?cation orcancellationofthisAgreement.
D. Waiver of any default shallnot be deemedto beawaiver of any subsequent default. Waiver
ofbreach of any provision ofthis Agreement shallnot be construed to be amodi?cation of
the terms of this Agreement unless stated to be such in writing, signed by an authorized
representative of Countyupon resolutionofBoard.
Article XII -- Single Instrument,Legality
A. It is understood and agreed that the entireagreement oftheparties is contained herein and that this Agreement supersedes all oral agreements and negotiations between the parties
relatingto the subjectmatter hereof,as wellas any previous agreements presently in effect
between the Provider andCounty relatingto the subjectmatter hereof.
B. The provisions of this Agreement are severable. If a Court of law holds any paragraph, section, subdivision, sentence, clause or phrase ofthis Agreement to becontrary to law, or
contrary to any rule or regulation having the force and effect of law, such ruling shall not
affect the remaining portions of this Agreement. However, upon the occurrence of such
event, the parties shall immediately meet to negotiate arevised Agreement, which does not
IN WITNESS THEREOF, County and Provider agree that this contract iseffective from
January 1,2018 through December 31,2018
PROVIDER:
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COUNTY:
Cook County Public Health &
Human Services Board
Jagciueli?e
Sebastio?1/
Date: C)’:
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Approvedas to formand execution:
Molly
Hid/ken
County Attorney Date:
Heidi Doo-Kirk, Chairperson
Date:
Public Health&Human Services
A{‘I§on‘McIntyre Director
CookCounty Public Health & Human Services FUND BALANCE
History of Use of Fund Balance and Fund Balance 1,200,000
PLANNEDUSE ACTUALUSE OF DIFFERENCE DIFFERENCE FUNDBALANCE 1000000 OFFUND FUNDBALANCE BETWEENPLANNED BETWEEN DECEMBER31
800 00
BALANCE AND ACTUALFUND PLANNEDAND ' °
ALANCEACTUALOUT OF 600,000 (131,610) (261,875) (130,265) (119,690)’ ” 1,010,916’ 400,000 (99,047) 60,173 159,220 76,916 1,071,088 200,000 (13,025) 27,218 40,243 24,383 1,098,306 0 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
(13,653) (18,859) (5,206) (78,534) Graph: Fund ?a?g? — Balanceat yearend,forlast10 years
(20,393) (48,967) (28,574) (18,272) 1,030,480
HistoricalUseofFund Balance
(79,570) (182,558) (102,988) (66,431) 400,000 (79,570) (163,333) (83,763) 95,285 300000 (82,739) (41,779) 40,960 4,800 2001000 (100,896) (100,896) 227,390 100000 (27,671) (27,671) (73,579) 0 323,527 323,527 (262,657) T (100,000) (521,205) (471,052) 50,153 (257,466) 2007 2010 1 2012 2013 2 2017 (200,000) (300,000)
Graph:Fund Usage - Belowzero=usage; above zero=returnto fund
