Health & Human Services Committee - Regular Meeting

Welcome to this month's edition of our Health and Human Services Committee meeting. We will begin here. We're in the West Square building, room 213, bare boot. Again, 530, I'll call the meeting to order and certify compliance with the open meetings law. Thank you. Number two, adopt agenda. I'd be looking for a motion to adopt the August 25th agenda. So moved. Second. All right, we've got a motion by Supervisor Soprino and a second by Supervisor Clemens. All in favor? Aye. Any opposed? Motion carries. Thank you. And number three, approve minutes of the previous meeting. Those were attached to Granicus, so I'd be looking for a motion to approve the draft minutes from July 28, 2026.

Make a motion that we approve the minutes.

Second. Thank you. We got a motion by Supervisor Clemens and a second by Soprinko. Were there any discussion or comments, changes to be made? All those in favor? Aye. Any opposed? Motion passes. We have passed the minutes from the July 28th meeting. Number four is public comment. However, I don't see anybody in attendance, and I don't think we have anybody online. No.

Thank you, Julie.

All right, we will move on to number five, which are communications emailed. Okay. Oh, forgive me. As long as we do have you in attendance with us, Supervisor Soprinko, we'll just go around the room and do a little introduction of everybody so we'll get to know each other a little better. And I haven't heard from Citizen Funmaker, so maybe she's in love. Either one. Well, that's right. I didn't hear from Tom either.

Okay, thank you. But why don't we start with you, Supervisor Soprinko. Welcome. Hi, I'm Wally Traprenko. You may have noticed by me making motions, it's not my first rodeo. I was on the board previously a few years ago, and I'm District 1 for Lake Delton. Nice to be here. Hello.

I'm Diane Reinfeldt, and I work at MATC, and I'm a community member of this board.

I'm Elaine Vita. I'm a citizen member. I'm a retired physician.

I got this thing on my finger.

I'm a nurse.

Susie?

You're covered. I'm Susie Titone, representing District 27. I forget. Sorry.

All right. I'm Dave Lemons, a retired dentist living in the Dells and representing the town of Dalton area, Mirror Lake area.

We farm over in District 6. It's Village of Rock Springs, Town of Reedsburg, Town of Delona, and a little bit of Excelsior.

Jennifer Whitesell, Director of Public Health.

Jessica Migel, Human Services Director. Stephanie Box, Business and Administrative Services Manager for Human Services. Jessie Phelan, Deputy Director for Public Health. Julia Darkel, Specialist.

All right, well, we have some administration in the back.

Well, he knows me. We grew up in the same town. Yes, we did. Wasn't prom great. Back here is court counsel, Jim.

Lisa Wilson, administration.

Hi, Lisa.

All right, so if we have anyone else enter, otherwise I do have two unexcused ads at this time. Moving forward, we've got number five, communications emailed. We have nothing posted to Granicus for human services, but there were four attachments on Granicus with public health. Were there any questions regarding those attachments? Is everybody able to access them? Perfect, thank you. All right, the number six department updates. We'll start with A, Human Services Director's Report. Take it away, Jessica.

Okay, just sort of staffing updates. A few of these I might have mentioned last month. We have a vacancy in our crisis unit. So I'm down a crisis position right now. We are down a position in our business unit. And still down a position in our child protection unit for a family support position. So three vacancies right now. We have a pending offer for the family support position in CPS. Actually, there was a first round of interviews for the crisis position. No offer was made out of those, so that position was reposted. Hoping we get a better round of candidates the next time. And the business position has been posted in interviews there in a couple of weeks for that. Knock on wood, we get some folks in there. I just wanted to mention that Baraboo hosted its first national night out this past weekend. Actually, Jenna Greenwood, who is one of our child protection services managers, helped the Baraboo Police Department in the planning of that event and had a booth there as well. So this was their first year doing it. The goal is to support positive interactions with law enforcement and other community agencies. So I think there wasn't a great attendance, but this was the first year, and they're looking at ways they might do some things differently next year. So just wanted to mention that. We did submit a letter of intent for a rural health transformation grant. I don't know, I can't remember if we've mentioned these previously, but there's a lot of money at the state level right now in what they're calling the rural health transformation grants. Number of different pots of money with different purposes. So with the support of Jennifer, her staff, we submitted a letter of intent for a care coordination grant. So if they accept that first round, what we do is get some initial funding for a planning phase. So I think it's six months. We would get funding for six months to embark on some planning phase. And then to submit a larger proposal for what would be, I believe, five years worth of funding. So we're looking at an opportunity to look at a co-responder model with law enforcement where we would embed a crisis worker with one of our law enforcement agencies, at least one to start. And then also looking at some additional case management internally to support referrals that may come through the Crisis and Law Enforcement Avenue, and some other things. I think we wrote in some peer support and some other things such that. Anything you can recall that I'm forgetting? No, that's it. So we will let you know what happens from there. A lot of applications, we know many entities locally have not applied, so it is going to be competitive, but there are also a lot of funds, so we'll just wait and see what gets offered. I just wanted to mention our Popsicles in the Park program. I mention this because it's just a nice positive. It's wrapping up this Friday with a rescheduled event. This is our Birth to Three program where they go out and host children and families in the community to try to sort of build some community. I did ask about numbers and they said they think they've served about 40 families and 100 children this summer. And the timing was interesting today because at two of those events they had Dolly Parton's library there. And so with the passing of Dolly Parton today, I just wanted to mention that. So it was a really nice partnership with that library where they were able to give kids who attended a free book as part of their attendance there. And then a not-so-positive news, we did find out last week that our institution costs at Winnebago and Mendota are going up another 10%. So this has been, ever since I've been in this role, there has been a 10% increase annually, and we're being told that will be happening again. And that usually goes into effect, I think, in October, actually, doesn't it? I don't think it's January 1. I think it's typically 10-1. So I haven't seen the official communication around that, but that is what we're being told, is that we have another Significant increase. I should have ended on the popsicles in the park. Sorry.

I just have two, just relating to the increase. So are those the numbers, the increase is what you use for the budget? I mean, you were aware of that prior to meeting with Lisa?

Well, no, I just, no. Okay. I just found that out on Friday at my director's meeting, so we get updates from the state at that meeting, and that's where that, I haven't had a chance to communicate that to Lisa yet.

All right. I think the other thing to say, too, is we kind of took a risk with our that a waiver will go through to pay for the people in the institutions that are 21 to 64 right now. MA does not pay for them. But this waiver, if it gets approved, it will, and we're hoping it will. So we took a significant risk in our banking on that going through.

And just a follow-up question, if it did go through, would that be Jan 1 then, or...? Well, the rate increase will happen regardless.

We don't know because the state, if the waiver is approved at the federal level, then the state still has to implement the waiver. So we're being told that federal approval should come through my final quarter of this year. And so the question mark is how quickly we will get that implemented. Or whether there'll be any back dating to that too. That would be the other question. We don't know yet.

It is a risk.

Thank you.

And the other one was just the community night out or whatever you called it. I was just curious, do you know how that was advertised? Because sometimes with public health, we get an email or something kind of knowing what's going on. I never heard it on the radio. I never knew about it. So I guess I'm just kind of curious.

I don't know, technically this really is the police department's thing. Primary. Primary, right. We offered to support just because of our partnership with them and them requesting some help from others. I don't know a lot about how they advertised it, but I think there were lessons learned and that certainly... Sure. I don't, because I didn't hear about it either. I don't live in Baraboo, so... But I think it could probably have been better advertised. So I can bring that feedback back.

Well, see, because I don't know about you guys, but sometimes if I hear those things, I try to attend or share or something like that just to make it known. But thank you, sorry about that. Thanks for bearing with me. Then we'll go with item B under number six, the public health director's report. Jennifer.

Short and sweet. This month we have no staffing updates. And I just wanted to share that with the suicide prevention grant that we received, we've done quite a bit of outreach via social media, billboards, hopefully you've seen them. And with that, the goal being to direct folks to the Credible Mind website, which offers a plethora of free mental health resources. We saw a 200% increase in the traffic to that website in the month of July, with mostly new users. Still, the topics most sought were... Postpartum depression, anxiety, anxiety and depression were the top searches at that website. So by all accounts, it looks like the outreach is reaching folks who then are visiting the website. Lettuce, still questionable. But for this month's communicable disease update, unfortunately we're back to measles. And with that, I will turn it over to Jessie.

Okay, so most currently in Wisconsin, there are 42 confirmed cases, and they are in the counties of Grant, Iowa and Lafayette and there are 17 additional probable cases and then just a little bit about what we're doing we are we're trying to get out there and do some education answering answering some phone calls getting some extra vaccines ordered and doing a couple extra vaccine clinics and just doing an outreach wherever we can so trying to keep up with that so any questions

I have a question about the Credible Mind stuff. I think I talked to you about this before in the past. Are the high school, you know that green bandana club in the high school? They do the mental health kind of stuff in the high school. Are they aware of this website? I mean, have you talked to their... You know, the club advisor? Sure.

Jesse, do you want to? I don't know about the club advisor, but the schools have been made aware of the platform.

Of the platform, okay. And, you know, you guys sent out that, like, a Zoom conference for the community. That was one of the things I thought I got. Oh, was that a P4P partnership? Prevention, yeah, yeah. And there was one section that was for the community, you know, how community members can, you know, So I forwarded that to the school because I was hoping that.

So that's great.

Yeah, that they, you know, but it's early in the school year. I think it's September 7th or something like that. I can't remember. It's early in the school year, so I don't know. I mean, I gave it to one of the school board. Yeah. September 8th. September 8th, yeah. So he promised he was going to send it. But I thought that was awesome, you know, because it's Zoom. The kids should be able to, you know, watch. I think it's noon to 1. Or 11 to, yeah. You know, so it's like lunchtime maybe, you know. Anyway, I just thought that that was a good thing for the community to do.

Yeah, absolutely. We're just trying to get that out far and wide for folks. It's free, and if you have internet, then it's accessible. Yeah, exactly. Next month, I could bring, we do get a monthly report from Credible Mind, and it does give the age breakdown information. So if you're interested, I could make one of that.

I would, yeah. And I can bring that with me. How much of that are the kids, really?

I don't know if you have posters, but I'd be happy to hang one up at MOTC.

We have posters, we have bookmarks, and business cards.

There's some window frames, too.

I could put whatever you think is appropriate up. Yeah, MOTC would be great.

Yeah, if you want to bring that. Sure.

Perfect, thank you. Anybody else have questions? I'm just going to take a minute here to welcome Citizen Member Funmaker for joining us. And just to let you know, our new county board supervisor is next to you, Mr. Soprano. We did a few introductions, and I just want to make sure you knew his acquaintance. All right, thank you. We'll move on to number seven, business items, human services, and begin with letter A, discussion and action to approve human services monthly vouchers. Stephanie.

Yeah, so just a couple line items to talk about. Salary and benefits, we had a decrease of 327, 730, 71, and this was due to having had prepaid periods that hit the books for the prior month. Community living and support, we had a decrease of $99,867.69 and we just had an overall decrease in our comprehensive community services, community service expenses paid for the month. And then lastly, institutions, we had a decrease of $63,877.96. Good news is we had two ended child-carrying institution placements. Bad news was that we didn't get our July juvenile corrections bill, so that was not included in there.

Any questions there for Walker?

All right, then we've got the item B, discussion of human services accounts receivable and the monthly reports. Oh, I'm sorry, yes, I scrolled past that. My apologies. Second. All right, we've got a motion to approve by Supervisor Soprano and a second by Supervisor Clemons. We're on the roll. Any discussion? Any questions? All in favor?

Aye.

Any opposed? All right, we have paid the monthly vouchers with my apologies. Thank you. You could have jumped in a little sooner and saved me there, Soprano.

I feel how you guys roll up in here, you know, so I'm just kind of hanging back. You hang back.

Okay, discussion of human services accounts receivable in the monthly reports. Thank you, Stephanie.

Yep, so we have the accounts receivable and then our volatile line report. So the accounts receivable is as of July. We do have an increase in our accounts receivable. Just a quick explanation, the biggest part of that is our Medicaid CCS, and we're normally several months behind on billing that due to how many outside providers we have and waiting for them to get all of their notes in. And then we have to check them all. We have to do corrections and so on and so forth. So the one thing about CCS Medicaid is we have a year to bill. So that's the biggest part of our accounts receivable. And then we have our collections. So, of course, we have our accounts that we're sending to credit management and the ones to state debt collections. You can see the amount that we've received so far. Credit management spent just a little over $8,477.78. State debt collections, $14,407.88. And our trip revenues, which is tax intercept, is $21,266.61. And we haven't had any hardships authorized yet for 26. Any questions on the comfortable report? And then our volatile line report. So these are our accounts that, I guess I don't want to say we don't have any control over, but... Most of them are placements, and so if someone has to be placed in residential or child ultimate care, that's why they're volatile. So we're still showing to be over quite a bit in our volatile lines. Again, adult residential, institutions, child ultimate care, just all big line items that are over. Anything else to say on that?

No?

I was trying to find anything different to say than what I said last month and the month before. No, I mean, I think internally we continued an ongoing discussion and there are certain placements over which we do have some control, I would say, and we do what we can to try to mitigate those. I think the children's placements are harder and oftentimes we have court-ordered placements and those are that we don't have control over. The judge has ordered somebody into a placement, so we do what we can. But as I've mentioned many times, the cost of all of these placements also go up every year, and so it's not necessarily that we're placing more individuals, it's just that the cost connected to placing the individuals continues to rise without any revenue to offset that.

I was curious, when you talked about Mendota and Winnebago, I know some of those are like emergency, you know, something happened, they go there, but do we have any long-term residents there?

Well, typically, I mean, sometimes we have somebody who will be at Winnebago for an extended period of time or at Mendota. With Winnebago in particular, they're not necessarily designed for that. So if it's felt that somebody isn't able to sort of discharge back to the community, we may look at another placement. So for instance, a step down, like would be to Tremblay, or we might look at... maybe a more supportive like assisted, not assisted living, but like an adult family home or a CBRF for them. But they won't discharge until they're stabilized. So we unfortunately have had a few folks with very complicated mental health presentations who have not responded well to any medication and those become very challenging cases if they remain unsafe to themselves or to others.

Yeah, and in this institution line is also Willow Creek and what was the other one? There's the one in Green Bay and the one in Willow Creek's Green Bay. And they're kind of like private institutions. Yeah.

Okay.

And they're typically short-term. They're not going to keep somebody for more than a few days to a week typically. Okay.

So like that 10% increase that's going to happen hopefully is more shorter term people?

Well, it's hard to know. Again, it depends on the case, right? I mean, if we have somebody who has insurance and they're willing to go voluntarily for a hospitalization, that's the route we want to use, right? We'd like to support them voluntarily anyway. That's a preferred alternative to an involuntary hospitalization, but is the folks who we can't work with in a voluntary way that we end up detaining and they often do end up at Winnebago because our private hospitals either typically they just decide maybe their presentation is too severe especially if they're going to have to do any sort of isolation or separating from other patients the more private hospitals don't want to do that so then they by default end up at Winnebago or Mendota

And I think, too, you know, in years past, the makeup, you know, maybe unfortunately has been maybe more kids. So under 21 and those that are over 64 or 65. And then MA will pay for them. And so we saw some lower costs. I think right now the bulk of what our admissions are that age group we're not getting any reimbursement on.

Anything further? Did you bring magic dust?

I always have some in my pocket.

We've got a few problems.

387C, are you ready for the discussion and action to approve the collections request?

Yeah, so we have four accounts ready for state debt collection for 1,208.39 and five accounts for credit management for 795.85.

I'll make a motion to approve those.

I'll second that. All right, we've got a motion by citizen member Reinfeld and a second by citizen member Well, I'm enjoying the blame. I mean, lame. Vida. Thank you. All right, the amount of $1,208.39 for the state debt collections. I have four of those and five for credit management. The amount is $795.85. All in favor? Aye. Any opposed? Motion carries. Thank you, Stephanie. And then we have item D, discussion and action for purchase of Acumatica financial software. Is that you, Jessica? I'm going to let Stephanie answer.

Or Stephanie. Perfect.

Hey, she's doing a fine job. Carry on.

Sure. So we currently have Geneva Financials, and the software is called Quantum. So back in, just give a little history, back in 2012, we were losing our electronic health record at the time which also included our financial software. And the people that bought out the company gave us a deal to move all of our licenses over to this new electronic health record which is Avatar, what we have now. Their relationship happened to be with Geneva Financials for the financial software. It was pretty cheap. We ended up going forward with it. Well, we received notice, like it's been a year and a half maybe ago, a little bit longer than that, that they are going out of business. They're retiring. They're... Basically, the software is kind of antiquated, and so they gave us notice. So we've been doing some research in regards to replacing that financial software. The county has Tyler Technologies, and we did see demos on that along with Lisa and Jessica in accounting. And then we internally saw demos on Acumatica, which is the vendor that has the current relationship with NetSmart, which is our electronic health record. And so I think after seeing the demonstrations, we were, I think, all in agreement that Tyler was not going to work for us. The price was pretty comparable in regards to what it was going to cost to implement Tyler and the annual cost with what Acumatica is going to charge. And so I guess we're coming here today to try to get approval. to move forward with the purchase. We are running out of time. August of 2027, which may seem very far away, is when quantum will cease to exist. And so we have less than a year to try to get this up some financial software up and running. We also have interfaces with the state that we have to bring into our financial system. We have interfaces with MUNIS, which is the county system. We have interfaces with our electronic health record. So all of this has to get working and we have to run it side by side with Quantum to make sure, you know, everything works. So, I don't know, Jim, do you have anything to add?

Yeah, I just came in case there were questions from a procurement perspective, but we did check with the state's contract through the Department of Administration just to see if we could secure it more cheaply because they on that competitively bid contract. And then just a reminder, the purchasing policy here does say that the home committee can actually waive those RFP bid requirements anyway, but this particular department has an exemption from the whole process whereby this committee just approves the purchase as opposed to having to waive the procurement processes. We are totally okay from a procurement perspective, and we may even be getting it cheaper than an enterprise-level contract for the whole state. Thank you.

All right, we'll open the floor for questions, curiosities. Go ahead.

And the Acumatica, you said, integrates more easily with some existing software you're running?

So it is the preferred financial software or has a relationship with NetSmart, which is our electronic health record. And so we do have an interface with NetSmart that will be much easier to manage if it is with their partner rather than a different one. And the reason I know that is because after we signed with Quantum, NetSmart and Geneva Financials had a falling out and they were not going to allow us to like Geneva wasn't allowing us to have access or NetSmart to have access to certain things and it was a mess for a bit but it got worked out and actually the software and the relationship while they were separated it worked out okay so yeah.

Anyone else? Do you want the price? Yes.

Yeah, okay. So implementation costs, so the third-party implementation services and project management, that's $94,900. And then the year one cost is $2,600 for the price to do this. So total year one cost is $121,600.

And Stephanie, I just have one follow-up question if you don't mind. Oh yes, two. As to a comparison as far as what, I mean I know it's antiquated, but what either what we paid for what we have now, or is there an annual renewal? You had mentioned year one, but are there costs going forward?

Yeah, so every year there will be the license fee and the module fees and stuff like that. So year two is $2,900. I don't have anything beyond that.

So we would anticipate from the $2,600 to $2,900, it would just be... exceeding that year after year?

Well, potentially. I mean, it just depends.

Sure, thank you. Anybody else?

What do we have budgeted? Nothing right now. No, I mean, we have, I mean, we do have something. So we have our current financial software budgeted. We did budget for 2027 for whether we went with the higher cost in our 27 budget to pay for the new financial software. But it's really the implementation fee that we don't have budgeted. We do have like 40 some thousand I think in our MIS budget for upgrades and things like that. So I mean we do have part of it covered. I think maybe we're going to try to absorb it somehow in our budget. And then a lot of, some of this I can also claim then through Wimper because we run our CCS through their CCS program and all of our programs. So that implementation cost and then the ongoing cost will be claimed through there too. So there will be definitely some reimbursement, but we won't see that until we reconcile that following year.

Perfect, thank you. I guess I'd be looking for a motion to approve the action for purchase of Acumatica financial software. I'll second that. Perfect, we've got a motion by Supervisor Titone and a second by Vita.

Any further questions before I call the question?

All right, all those in favor? Aye. And any opposed? Motion passes. We have approved the purchase of Acumetica financial software.

Just as a side note, our current only costs us $8,000.

Wow.

A month? No.

No. Annually.

But I would imagine you mentioned 2012. Initially, there was probably more of an implementation.

The implementation was like 50-some thousand at the time. Yeah, but then it's just, it's really, it's a small little company, and yeah, you just can't find that cost anymore.

So every county has their own system they choose? Wouldn't it make sense that the whole state would talk to each other?

Well, we do have a spreadsheet. So I did look at a spreadsheet. They did gather that from a lot of the counties our area admin did. And quite a few have Tyler, but if you talk to them, they are all doing things manually with Tyler. They are pulling data into an Excel spreadsheet, and they're trying to sort it to do their reporting. Because Tyler really doesn't write reports for you. You would have to have someone who knows SQL or time to be writing all of those reports. So at my last financial managers conference, that was... One of the presentations was, like, this person who was showing all these great things an Excel spreadsheet could do. And I said, don't you have a financial software that you pull reports and, you know, compiles it all? Well, we have Tyler. Well, don't you have reports?

No. Do you know how to get them?

So, I mean, there's not a lot of good, you know. And the potential for error. Yes.

when you don't have that.

Well, right. I mean, how are you reconciling everything? We have a report that pulls all of our expenses, and then we reconcile all our reports to that. I mean, all of our reports we do to the state are compiled exactly how they have to be to the state, and we can just input numbers. I couldn't imagine going backwards. Thank you for, you know, yeah.

I live in an ideal world. Yeah, right?

Not the real world, yeah. All right, folks, then we're on to item number eight, the business items public health. A, discussion and action to approve the public health monthly vouchers. And that was attached to Granicus. I guess I'd just be looking for a motion for the amount of $106,077.10. That sounds like a good small one, I'll do that one.

Perfect, all right, we have a motion by Supervisor Soprano and a second by Citizen Member Fundmaker.

Any questions? All right, all in favor? Aye. Aye. Any opposed? Motion passes. We'll pass the vouchers in the amount of $106,077.10. Moving on to item B, public health budget report and grants overview. No updates. No updates. Short, sweet. Number nine, other reports and updates. A, the Wisconsin Association of Vocal Health Departments and Boards.

We meet tomorrow, so I will bring that next month. Perfect. I'll be a month behind given the change in the scheduling of this meeting, so I will report back next month.

Thank you. Item 10, next meeting. We're scheduled for the fourth Tuesday of the month, and that would be September 22nd at 5.30 p.m. here at the West Square building in room 213. And that works for your schedule?

Indeed.

Excellent. All right, moving right along. If you have any agenda items for the next meeting as listed in item number 11, please let me know. Or if you have any other suggestions. Oh, that's right. Yes, we already said that last month. My apologies.

And I am still planning to have Gina come at some point to talk about the food share changes. Maybe next month doesn't make sense.

I was going to say, maybe in October. October, November, whatever works for her.

And can you address that email I sent you? Would you like it as an agenda item? Yeah, is that okay? I mean, just... Yeah, I just... Or is that too much or too early? Sorry, I'm thinking.

Can we revisit it next month? Like, can we revisit that as an agenda item next month? Just so I have a chance to, like, look it through and figure out.

And just a suggestion, because I read, oh, what?

Yeah, I just don't know. I don't know a lot about it at this point, and I'm not sure how much of an educated update I'll be able to give. Maybe by October. Okay.

And just another thought is that could you give it to Julie as a communication so that maybe the rest of the group could look at what you had provided? And then going forward, would you like an agenda item? Because I just know it's a pretty vast subject. Yes. I hate to get out in the weeds with everybody here with just a specific agenda item that doesn't. I mean, it directly affects the county, but at this point, I just don't know how tangible the details are going to be. Thank you. That was sort of what I was trying to articulate.

I don't, at this point, have a lot of information that I could provide an update or information about the impact on us.

I may know more moving forward.

It just really hasn't been addressed at any of my state meetings, director meetings, so again, I don't know why necessarily, and I will seek to find that out, but I think in terms of having a tangible...

I think I just wanted people to know that it's coming kind of and there's certain concern Yeah, just call Sunday as a communication, okay our group here and then everybody a little feeble is up with fine Yeah, okay. I just gave her a cop her it okay, and so that'll be electronic and then item number 12 adjournment and Motion to adjourn. Motion to adjourn. I'll second. I'll second. Mr. Clements, all in favor? Aye. Any opposed? All right, we're adjourning at 6.09. Thank you, everyone. We'll reconvene next week. That was very quick.

Anybody want to buy a raffle ticket? $10 for a chance to win $5,000.

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And then the 52 cases in the world for 2025. So far this year, Pakistan only has three cases.