1:30 P.M. PLEDGE OF ALLEGIANCE. WRIGHT COUNTY HUMAN SERVICES BOARD MINUTES The regular meeting of the Wright County Human Services Board was called to order at 1:30 P.M., Monday,, by Chairperson Sawatzke. MINUTES: Approval of Minutes of July 14, 2014. Action: The Minutes as written were moved for approval by Potter, seconded by Husom. Motion carries AGENDA: Action: The Agenda was moved for approval by Potter, seconded by Borrell. Motion carries ROLL CALL: Members Present: Christine Husom - District 1 Michael Potter District 4 Pat Sawatzke District 2 Charlie Borrell District 5 Member Absent: Mark Daleiden District 3 Staff Present: Carol Schefers, Public Health Director Christine Austin-Roehler, Health Promotion Coordinator Shannon Anderson, Family Planning Public Health Nurse Catherine Main, Public Health Nurse Richelle Kramer, Social Services Supervisor Erin Baker, Social Worker Michelle Richer, Social Worker Tammy Peterson, Mental Health Professional/SW III Diane Erkens, Social Services Supervisor Kimberly Johnson, Financial Services Manager Christine Partlow, Fiscal Manager Aggie Gunnerson, Secretary Others: Jodi Painschab, Buffalo Clinic Clinical Supervisor CONSENT AGENDA 1. Social Services Payments Abstract $177,523.53 Action: Motion by Borrell, seconded by Husom, to approve the Consent Agenda. Motion carries REGULAR AGENDA ADMINISTRATIVE PAYMENTS: Action: Motion by Potter, seconded by Husom, to approve the Administrative Payments in the amount of $3,809.50; 35 vendors; 54 transactions (abstract 1), and $86,583.20; 36 vendors; 147 transactions (abstract 2), subject to audit. Motion carries SOCIAL SERVICES/PUBLIC HEALTH/FINANCIAL SERVICES: 1. Family Planning Program One Year Later Christine Austin-Roehler said a year ago, in July, we began our new funding program for family planning.
H.S. Board Minutes Page 2 Our staff started working intensively to get the program up and running. We had many meetings with the clinic group of the Monticello Clinic, Buffalo Clinic and the Albertville/St. Michael Clinic. Public Health nursing staff spent time on getting client forms in place, and on our protocol. In September 2013, we saw our first client. In the last year, we have seen approximately 70 medical clients and provided a full range of services. We have counseled nearly 180 clients on over-the-counter methods; people not seeking out the medical services. We value the partnerships with the clinics. Jodi Painschab spoke on collaboration with the Agency. This has been a positive thing for our community. We have seen the progression of improvements in workflow and policies to provide this service to the community. We have worked well together to provide this service. Austin-Roehler said we serve men, as well as women. Our second client was a male. All clients going to the clinics receive screening for sexually transmitted infections. The highest infectious disease in the State, nation and County is Chlamydia. We provided about 33 tests for sexually transmitted infections. We are striving to reduce barriers; clinics offer exam rooms for Shannon to provide counseling before seen for an appointment. Some clients need interpreters because they have difficulty understanding English (paid for by the grant). Once a week during the school year, Shannon is seeing high-risk students at the Wright Vo-Tec Center. She talks to and counsels students, and help them get medical care when needed. Jean Peterson, Dean of Students, has said by Shannon being in their building has prevented pregnancies with four teenagers by receiving appropriate contraceptive care. We work with teens at the other alternative care centers in the County. We have had people of all age ranges up to the age of 40. The program is needed, not everyone has insurance, there people are new to the area who haven t found jobs or medical care, or women in an abusive situation. Shannon Anderson shared a story of a young girl switching her birth control methods, she went to the clinic and did a random STD screening, and tested positive for chlamydia. Austin-Roehler said women come to us who have been sexually assaulted. A program is available in the emergency room that provides medical treatment and care, and prophylactic medication. Through the Family Planning program, we are able to make appointments with the clinics so clients get the proper care, and prophylactic care. Another part of our program is Outreach and Education to prevent pregnancy; our 2 year goal is to see 2500 people (either individually or in groups). Christine, public health nurses and our Sexuality Consultant have done that. Delia Winter is our new Sexuality Consultant, and is an asset to our team. She goes to group homes and the jail (have provided classes for 20 years). Jo Carpenter, program coordinator at the jail, said we are providing true education to the inmates and adds real value to their program. We go to group homes, almost all of the alternative learning programs, and high schools this is by invitation. Last year, July 1-June 30, we had almost 2300 contacts with youth or adults in promoting our program with goal of reducing unintended pregnancies, especially in teenagers. We do public information in the community - have flyers, done news releases in papers/radio, promotions through the Early Childhood Education program, WOW Van promotes our program and does referrals, and have distributed 10,000-15,000 Who Ya Gonna Call cards. Austin-Roehler said they have initial conversation with clinics in the western part of the County, and they are looking forward to working with us next year. Areas include Annandale and Cokato. We will the have the entire County covered. We may do Chlamydia testing in the office and for inmates in the County jail for people to get proper antibiotics. Potter said the earlier you intervene, the better off you are. Austin-Roehler said workers have SMART phones; can do texting with client that has helped with communication with clients. Overall, the first year has gone well. She thanked the Board for their support for the program. Borrell asked what is the grant amount. Austin-Roehler said the grant covers a two-year period, and is over $471,000. The grant covers staff time of 1.5 FTE, service at clinics (visit and testing), medical service, contraceptive testing. Borrell said you saw 70 clients in medical clinics for $235,000. Schefers said the grant also covers all the education and everything Austin-Roehler talked about. Austin-Roehler said it pays for coordinator s time, education, training time, and the contract
H.S. Board Minutes Page 3 person (Delia Winter who works about 12 hours per week provides outreach education for high-risk people, etc.). Borrell said, when you came to us last year, Wright County Community Action was handling the family planning. Austin-Roehler said they had the medical services; we always had the outreach and education portion of the grant. We now have the medical services also. He said how much extra is the amount we get now. Schefers said Shannon was hired in November of last year to take someone else s place, and we shifted what people were doing. Board thanked Christine for report. 2. Disease Prevention & Control presentation. Catherine Main reviewed her work history in Wright and Sherburne Counties doing disease prevention control. A report on Pertussis and Tuberculosis, currently in Wright County, was reviewed. The State Community Health Services Advisory Committee, in 2012, updated the local Public Health agreement regarding disease prevention and control and is basically the outline of Public Health and what we need to do. Each local Community Health agency needs to have a designated person to do disease prevention and control. Pertussis is on rise in recent years. In 2012, the number of pertussis cases went up to 274. California presently has a significant increase in Pertussis. In 2010, Wright County made the decision to do our own investigations of pertussis. All other reportable disease investigations are done in collaboration with MN Dept. of Health. We are seeing measles and mumps in the US and Minnesota, and overseas, polio is also coming back. A few months ago, Minnesota had case of lasa fever, originally found in Africa. TB has been around for a long time. In the past few years in Wright County, we had 2 cases of TB in 2012; and two cases in 2013. A person with the disease can spread it at their home, worksite; and the person needs to take antibiotics every day. We need to follow up on all contacts at their worksite, home, church, etc. Borrell asked how many of these diseases are we currently vaccinating for. Main said yes, there is a vaccine for pertussis. It was found, a person s immunity is waning, and for children (age 10-12) the vaccine is wearing off. A new vaccine (booster) for adults/children is available. Vaccines are the most extensively tested medication before going on the market. Borrell said if we are vaccinated, the chance of getting disease is minimal. Main said there are pockets of people, in Wright County, who do not believe in vaccinations. Diseases like measles are highly infectious. Borrell said out of these counts for TB and Pertussis, how many people were vaccinated. Main said the majority of the people investigated for pertussis are vaccinated. We don t have vaccine for TB; foreign countries vaccinate infants. The two cases last year; one was foreign born and the other had traveled to a foreign country. In 2012, both were foreign born. The case she is seeing now is foreign born. Potter anticipates more cases of diseases with children coming across the border. Main said pertussis will not go away. In 1990, there were 8.5 million active TB cases; 12 million in 2013. Many millions of people die from TB each year, mostly in third-world countries. Potter said with the flood of children coming in from Central and South American, and dispersing all over the Country, are we facing another epidemic. Main said the State notifies her of refugees/immigrants coming into the County and she sees they get followed up at a medical clinic. We have had some refugees from Belarus, they get medical evaluations, and there was nothing concerning. Some of the surrounding counties have large numbers of TB cases. Sawatzke thanked Main for report. 3. Child Protection and General Intake. (attachment) Erin Baker said workers present today are part of the new Intake/Assessment Unit, and she does Child Protection intake. A PowerPoint presentation was given (copies to Board). Tammy Peterson does children s outreach intake. When we do intake, we answer questions, find out where client needs to go, we are the first step coming in to Human Services for services. Michelle Richer said she is the general Intake worker does all opening of cases; Mental Health services, Developmental Disabilities, Case Management, and Child Welfare. Human Services doesn t do case management for those on PMAP for Mental Health services. She provided case counts for period of 2009 through 2013. There is significant paperwork for people to complete, gets releases of information, gets social history, determines eligibility and passes them on to case worker. She does all licensing complaints for day care providers and adult foster care; complaints have gone up. Potter referred to increase in Licensing Complaints, and asked if more people are aware of this. Richer said people are becoming more
H.S. Board Minutes Page 4 aware. When asked about nursing home complaints, Richer said those complaints go the State Office of Health Facility Complaints. Group home complaints also go to the Dept. of Human Services. The State is tight on their reporting process; complaint comes to her, she writes it up, and sends it on to the Office of Health Facility Complaints. Physician emergency hold orders come to our Agency from a doctor; she processes it and passes it on to the Mental Health Unit for investigation. Vulnerable Adult reports are high, and takes a large percentage of her time. Reports come from nursing homes, adult foster care, community and private agencies, and concerned individuals. Borrell said the nursing homes are not doing their job there is a stench, and would not want to live there. Richer said she encourages people to make a report, and sends report to the Office of Health Facility Complaints to investigate. The State does double reporting to make sure reports are made; they take reports seriously and goes out to meet with them. The State is doing what they need to do. She takes all calls for mediation and custody, general calls for housing, transportation, etc. The number of calls is high; we adapt and do the best we can. Baker said she takes Child Protection reports; talks with law enforcement, foster parents, family members, hospitals, clinics, day cares, etc. anyone that deals with children. A lot of the time, people say they don t know what to do and refers to appropriate person/agency. Most calls are on custody issues/arrangements, and refer them to their attorney. Currently in 2014, we average 1141 calls. The most is 16 calls processed in a day. Tammy Peterson said she is the children s outreach worker. If calls don t fit Child Protection, and more of an immediate crisis that Richer cannot handle it comes to her. Her position started in 2008 to help those children falling through the cracks and not enough to initiate Child Protection service. Communities, schools and law enforcement have determined the child needs some type of services. In 2008, she received 40 referrals; and in 2014, has already taken 71 referrals. Referrals come from law enforcement, school districts, screened out Child Protection reports, and other workers. She gave a couple of examples of a typical call. Her preference is that all work she does with the family is voluntary. Unique to her position is she tries to engage the family, but if we get into a situation where intervention is needed, she will file a CHIPS petition. Borrell asked if there is a common denominator. Peterson said no, in some families, mom and dad don t communicate; some may be due to child s mental illness and being impulsive; for some there is financial struggle and some where finances is not an issue. Richer said a lot of times the barrier is the client needs a current assessment. Peterson said out of the 71 referrals so far this year, 10 went children s mental health, 1 to child welfare, 14 were closed, 3 connected with their current county worker, 28 parents didn t respond or had PMAP, and 15 are currently open that she is assessing. She goes to Safe School meetings. Board thanked presenters for report. 4. Mental Health Advisory Council appointment (attachment) District 1 - Eric Wiedewitsch Diane Erkens said this is a consumer of services that has served on Sherburne County s Mental Health Advisory committee in the past. Action: Motion by Potter, seconded by Husom, to approve appointment of Eric Wiedewitsch to the Mental Health Advisory Council. Motion carries 5. Licensing and Resource Unit Training Day September 26, 2013, at Nye Park, Maple Lake. (attachment) Action: Motion by Borrell, seconded by Husom, to authorize the training as stated. Motion carries ADMINISTRATION: 1. Proposed Administrative Memo change - Fuel Cards and Transportation Funds. (attachment) Kim Johnson said her Division hands out fuel cards. When procedure/policy was created, the maximum amount was set by the Board at $1500, and would like that increased to $2500. Her staff need to go to the other building; it is difficult to live within those constraints. Cards are used by both Financial and Social Services.
H.S. Board Minutes Page 5 Action: Motion by Borrell, seconded by Potter, to approve proposed Fuel Cards and Transportation Funds revision. Motion carries 2. June 2014 Financial Statement. (attachment) Christine Partlow said Agency is at halfway through the year. Revenues are at 44%, and Expenditures are at 45%. Overall, we are in a good position. We did receive the first half of Property Tax. Revenues being down have a lot to do with the State revenue not coming in as anticipated (TCM, LCTS). Sawatzke said we seem to be ahead of last year at this point, and asked where we finished last year, how much in the black. Partlow said about $100,000, not a huge amount. Action: Motion by Potter, seconded by Husom, to accept the June 2014 Financial Statement. Motion carries 3. Public Health Director Comments. Carol Schefers said the Local Family Collaborative (made of schools, Human Services, and County agencies) has money for special projects. The Collaborative formed a sub-committee to look at Children s Mental Health issues in grade schools. They sent out a survey and worked with a lot of the elementary schools and it was incredible what came back on the needs in that age group. The grade school area has huge needs. The group decided to do a Mental Health Summit in November (half-day). The summit will bring together clinics, schools, and mental health agencies, etc. to see what we can do to fill-in the gaps. Schefers said Evidence Based Visiting Home program continuously does studies on these programs; that way they know what works. The Nurse Family Partnership has been around for 36 years; in Wright County, we have done it for six years. There is a decrease in Maternal and Child Mortality with these home visiting programs. The Nurse Family Partnership program is only for first time moms, and until the child is age two. Another study done is in the child maltreatment area cost of non-fatal victims is $210,000 for these children. Schefers said in Public Health they do a lot with Environmental Health, and meet quarterly work with Bill Stevens, of Planning & Zoning. We will be working on a Healthy Homes project. The State Environmental Health Continuous Improvement Board was newly created, and Carol is an appointed member on this Board. Many of the counties that have delegation agreements with the Food, Pools and Lodging, were having problems with the State. Wright County does not have this agreement - MDH does our licensing and inspections. The State decided it needed a Board that has both local and State people on it, to not only look that area but every aspect of Environmental Health. For next year, it will be mostly about the Food, Pools, and Lodging Delegation Agreements. This will be helpful for us when looking at Environmental Health. Environmental Health is the largest department at the MN Department of Health. We receive a lot of input from the State when something is going on in the County. She mentioned recent incident at Appleby s, and both the Monticello and Buffalo restaurants were affected. They found out it was a food product. The Dept. of Agriculture is now investigating the incident. The next regular meeting will be held at 1:30 P.M., Monday, August 11, 2014, in the Commissioners Room, at the Wright County Government Center. Chairperson Sawatzke adjourned the meeting at 2:50 P.M.