* This transcript was created by voice-to-text technology. The transcript has not been edited for errors or omissions, it is for reference only and is not the official minutes of the meeting.
          [00:00:01]
          GOOD AFTERNOON. 
          WE WILL CALL THIS MEETING TO ORDER OF THE HUMAN HEALTH AND HUMAN SERVICES, UH, REGULAR MEETING. 
          IT'S WEDNESDAY, MAY 22ND. 
          UH, ROLL CALL. 
          WE ARE HERE MINUS ANN. 
          SHE'S GONNA BE A FEW MINUTES LATE. 
          UH, THE AFFIDAVIT OF POSTING WAS POSTED ACCURATELY. 
          UM, WE'LL JUST STAND FOR A MOMENT OF SILENT PRAYER AND THE PLEDGE ALLEGIANCE. 
          I PLEDGE ALL, ALL ALLEGIANCE TO THE FLAG. 
          UNITED STATES OF AMERICA, PUBLIC FRUITION STANDS NATION, ONE NATION UNDER GOD, UNDER GOD, INDIVISIBLE, WITH LIBERTY AND JUSTICE FOR, FOR ALL. 
          ALL RIGHT. 
          UM, ARE THERE ANY CHANGES TO THE MINUTES FROM ANYONE? ALL RIGHT. 
          HEARING NONE, UM, THE MINUTES ARE APPROVED THEN. 
          OKAY. 
          UM, OUR FIRST, UH, ITEM OF DISCUSSION ARE, WILL BE DISCUSSION AND ACTION WILL BE THE ELECTION OF THE VICE CHAIR. 
          [a. Election of Vice-Chairperson]
UM, I WOULD LIKE TO NOMINATE, UH, SUPERVISOR GALLS. 
          ARE THERE ANY OTHER NOMINATIONS? YES. 
          I WOULD LIKE TO NOMINATE CHRIS BAS. 
          OKAY. 
          MR. BA. 
          OKAY. 
          THEY BOTH HAVE TO ACCEPT YEAH. 
          SORRY. 
          WHEN YOU ACCEPT THE NOMINATION SUPERVISOR GALL. 
          SURE, SURE. 
          OKAY. 
          THAT MEANS WE NEED TO VOTE. 
          THIS IS, YEP. 
          OH, WE, OH, THERE'S, OKAY. 
          . 
          MAYBE WAIT. 
          YEAH. 
          WAIT, WAIT FOR ANN. 
          YEP. 
          LET HER KNOW. 
          ALL RIGHT. 
          JUST TO GET YOU A QUICK UPDATE, ANN, UM, WE JUST OPENED THE MEETING AND, UH, THERE WERE NO CHANGES TO THE MINUTES. 
          SO WE ARE MOVING FORWARD. 
          AND THE FIRST ITEM IS THE ELECTION OF THE VICE CHAIR. 
          AND, UH, BRI SUPERVISOR GALL IS NOMINATED AND SUPERVISOR BOSSERT IS NOMINATED AT THIS POINT. 
          YOU HAVE A BALLOT IN FRONT OF YOU, AND SO NOT TO RUSH YOU, BUT IF YOU CAN , GET A PEN AND, UM, WE'LL TAKE CARE OF THAT PIECE OF BUSINESS FIRST. 
          MM-HMM. 
          , WE HAVE ONE VOTE FOR CHRIS BOSER. 
          ONE VOTE FOR CHRIS BOSER. 
          RYAN GALL. 
          CHRIS BOSER AND CHRIS BOSER. 
          OKAY. 
          SO CHRIS BOS. 
          SO FOUR, FOUR TO ONE FOR BOER. 
          ALRIGHT. 
          SO, CHRIS BOSER IS OUR THANK YOU. 
          OUR VICE CHAIR. 
          THANK YOU. 
          THANK YOU. 
          GET A MOTION, A SECOND TO APPROVE THAT. 
          OH, YES. 
          UH, COULD WE HAVE A MOTION AND A SECOND TO OKAY. 
          AND A SECOND BY SUPERVISOR GALATZ FOR, UH, THE VOTE IS THAT TO ACCEPT. 
          ACCEPT. 
          OKAY. 
          AND THANK YOU. 
          WE DON'T NEED TO ACTUALLY VOTE ON IT. 
          DO WE JUST ALL THANK YOU. 
          YEP. 
          ALL IN FAVOR, SAY AYE. 
          ALL IN FAVOR SAY AYE. 
          AYE. 
          AYE. 
          ANY OPPOSED? ALL RIGHT, THANK YOU. 
          YOU'RE WELCOME. 
          ALL 
          [b. HSD Children & Families Quarterly Report]
RIGHT. 
          OUR NEXT ITEM IS, UM, THE CHILDREN AND FAMILIES QUARTERLY REPORT BY CORAL. 
          WELCOME. 
          CORAL. 
          THANK YOU. 
          YEAH, THAT'S GOOD. 
          THAT'S GOOD. 
          OKAY. 
          THANK YOU. 
          THANK YOU. 
          AND GOOD AFTERNOON. 
          MY NAME IS CORAL KLEIN AND I'M THE DIVISION MANAGER OF THE CHILDREN AND FAMILIES DIVISION. 
          UM, I AM HERE TONIGHT OR THIS AFTERNOON TO TALK ABOUT TWO THINGS. 
          ONE, TO GIVE A BRIEF OVERVIEW OF MY DIVISION AND THE SERVICES WE PROVIDE, AND THEN TO REPORT OUT ON MY EOS OR MY STRATEGIC GOALS, UM, FOR THIS YEAR. 
          [00:05:02]
SO I THINK IN YOUR PACKET, YOU RECEIVED SORT OF A BRIEF OVERVIEW OF HOW, UM, THE STRUCTURE OF THE DIVISION AND HOW THE TEAMS ARE, UM, DIVIDED. 
          WITHIN MY DIVISION, I HAVE, UM, 30 FULL-TIME, UM, POSITIONS, FOUR OF WHICH ARE SUPERVISORY STAFF AND 26 WHO ARE DIRECT FRONTLINE STAFF. 
          UM, AND THE CHILDREN FAMILIES DIVISION IS RESPONSIBLE FOR STATUTORILY MANDATED SERVICES UNDER WISCONSIN CHAPTER 48, THE CHILDREN'S CODE AND CHAPTER 9 38, THE JUVENILE JUSTICE CODE. 
          UM, THIS DIVISION IS DIVIDED UP INTO FIVE UNITS WHO SERVE BOTH COURT ORDERED CLIENTS, UM, AND, UM, CLIENTS WHO MEET ELIGIBILITY, UH, REQUIREMENTS CAN, UH, VOLUNTARILY OPT INTO A COUPLE OF THE SERVICES THAT WE PROVIDE. 
          THE INTAKE AND ASSESSMENT UNIT, UM, DOES BOTH INTAKE AND ASSESSMENT FOR CHILD PROTECTIVE SERVICES AND JUVENILE INTAKE OR JUVENILE JUSTICE. 
          UM, CPS INTAKE, UH, IS THE ACCESS LINE, WHICH YOU MAY HAVE HEARD OF. 
          IT'S THE NUMBER ANYONE, UH, IN THE COMMUNITY OR ANYWHERE CAN CALL TO REPORT CHILD ABUSE AND NEGLECT. 
          AFTER THE REPORT IS TAKEN, UH, THAT TEAM DETERMINES IF THE REPORT MEETS STATUTORY DEFINITION OF ABUSE OR NEGLECT. 
          AND FROM THERE, THAT TEAM DECIDES WHAT KIND OF ACTION THE DEPARTMENT NEEDS TO TAKE. 
          IF ANY SOCIAL WORKERS IN THIS UNIT DO CHILD ABUSE INVESTIGATIONS STATUTORILY, THOSE INVESTIGATIONS CAN LAST UP TO 60 DAYS AND ARE COMPLETED WHEN THEY MAKE A DETERMINATION REGARDING CHILD SAFETY, UM, AND DECIDE EITHER TO SEND A CASE TO COURT, UM, IF THE SAFETY CONCERNS ARE STILL THERE, OR THEY CAN MAKE CLOSE THE CASE. 
          JUVENILE INTAKE ALSO RESIDES WITHIN THIS UNIT, AND THEY TAKE REFERRALS FROM LAW ENFORCEMENT. 
          UH, FOR YOUTH WHO ARE ALLEGED TO HAVE COMMITTED A CRIME. 
          THEY ALSO TAKE REFERRALS FROM SCHOOLS WHO ARE HABITUALLY TRUANT. 
          UM, THEY CAN, UM, SEND CASES TO COURT TO BE PUT ON A, A COURT ORDERED SUPERVISION. 
          THEY CAN DO A VOLUNTARY AGREEMENT WITH, UH, FAMILIES AND YOUTH FOR SERVICES, OR THEY CAN PROVIDE RESOURCES TO A FAMILY AND CLOSE THE CASE. 
          THE ONGOING CHILD PROTECTIVE SERVICES TEAM, UM, DOES CASE MANAGE FOR FAMILIES, UH, IN CHILD PROTECTIVE SERVICES WHO ARE UNDER A COURT ORDER. 
          THE FOCUS FOR THIS TEAM IS SAFETY, PERMANENCE, AND WELLBEING OF CHILDREN. 
          THE CASES STAY OPEN UNTIL PARENTS CAN SAFELY CARE FOR THEIR CHILDREN, OR A GUARDIANSHIP IS ORDERED BY THE COURT TO A RELATIVE, OR THE CHILD IS ADOPTED TO A NON-RELATIVE OR RELATIVE FOSTER HOME. 
          UH, THE ONGOING YOUTH JUSTICE TEAM, THIS HAS HISTORICALLY BEEN KNOWN AS JUVENILE PROBATION. 
          THIS TEAM DOES CASE MANAGEMENT FOR YOUTH WHO HAVE BEEN FOUND DELINQUENT. 
          THE DEPARTMENT MAKES REFERRALS FOR SERVICES AND TREATMENT THAT FOCUS ON SKILL BUILDING AND CHANGING BEHAVIORS. 
          AND YOU'LL SEE KIND OF, UM, ON THE TOP RIGHT ABOVE, UM, RIGHT TO THE LEFT OF WHERE I, I AM LISTED, SERONA RECOVERY. 
          WE CONTRACT WITH SERONA RECOVERY TO PROVIDE OUR COMMUNITY SERVICE AND RESTITUTION PROGRAMS. SO IF A YOUTH IS ON A COURT ORDER AND THEY NEED TO PROVIDE A COMMUN, UH, RESTITUTION BACK TO A VICTIM, OR THEY MAY BE ORDERED FOR COMMUNITY SERVICE, THERE IS A ONE FULL-TIME, FTE, UM, RESTORATIVE JUSTICE COORDINATOR WHO WORKS WITH THOSE YOUTH TO GET THEM SET UP WITH AN OPPORTUNITY TO DO COMMUNITY SERVICE OR EARN RESTITUTION. 
          THEY ALSO DO, UM, VICTIM IMPACT GROUPS, UM, SO YOUTH CAN UNDERSTAND SORT OF THE, UM, RESPONSIBILITY AND IMPACT OF THEIR ACTIONS ON OUR, ON OUR COMMUNITY, THE FAMILY SUPPORT TEAM. 
          UM, THIS, THIS TEAM REALLY, UM, SUPPORTS THE OTHER UNITS WITHIN THE DIVISION. 
          THEY PROVIDE SUPERVISED VISITS AND FAMILY COACHING, UH, TO FAMILIES WHO ARE, ARE WORKING WITH CHILD PROTECTIVE SERVICES. 
          THEY ALSO RECRUIT, UH, AND LICENSED FOSTER PARENTS AND SUPPORT RELATIVES WHO ARE CARING FOR THEIR KIN. 
          UH, AND LAST BUT NOT LEAST IS OUR FAMILY COURT SERVICES TEAM. 
          UM, I ACTUALLY HAVE, YOU'LL SEE HERE IT SAYS, UH, 1.0 FTE EQUIVALENT. 
          THE FAMILY COURT SERVICES PROGRAM ACTUALLY IS TWO SENIOR SOCIAL WORKERS WHO DO JUVENILE WORK, UM, PART THE PART-TIME. 
          THEY WORK WITHIN FAMILY COURT SERVICES DOING CUSTODY AND PLACEMENT EVALUATIONS. 
          SO THAT'S NOT ANOTHER WORKER THAT IS, THAT IS TWO SENIOR SOCIAL WORKERS DOING THAT WORK. 
          IN ADDITION TO HOLDING A JUVENILE CASELOAD, UM, WE DO THAT IN PARTNERSHIP WITH WASHINGTON COUNTY FAMILY COURT, AND THAT REFERRAL IS MADE TO OUR DEPARTMENT. 
          UH, AFTER THE EVALUATION IS ORDERED BY THE COURT, WE RECEIVE THOSE COURT ORDERS AND THEN ASSIGN A WORKER, UM, AND WORK THAT CASE, UH, UNTIL THE COURT ORDERS THAT WE WRITE AN EVALUATION. 
          THAT, THAT IN A NUTSHELL IS, IS WHAT WE DO. 
          ARE THERE ANY QUESTIONS I COULD ANSWER? UNLESS YOU HAVE SOMETHING ELSE? ANYTHING? 
          [00:10:01]
NO. 
          OKAY. 
          THANK YOU. 
          THANK YOU, CARL. 
          OKAY, THEN, UM, MY EOS INITIATIVES OR STRATEGIC GOALS FOR 20 24, 25, I BELIEVE THAT'S ALSO IN YOUR PACKET. 
          MM-HMM. 
          . 
          UM, THE FIRST ONE I'LL TALK ABOUT IS IMPROVING THE QUALITY AND CONSISTENCY OF ACCESS TO COMMUNITY SERVICES. 
          AND THIS IS REALLY AROUND, UM, THE INCREASED COMPLEXITY OF FAMILIES AND CHILDREN'S COMING INTO, INTO OUR SYSTEM, WHETHER IT IS THE CHILD WELFARE SYSTEM OR BEHAVIORAL HEALTH SYSTEM. 
          SO THIS IS KIND OF A DUAL INITIATIVE, UM, ALONG WITH BEHAVIORAL HEALTH. 
          THIS INITIATIVE SEEKS TO STREAMLINE CLIENT ACCESS TO CHILD, ADULT, AND FAMILY SERVICES TO INCREASE CLIENT ACCESS TO COMMUNITY PROGRAMS THAT IMPROVE CLIENT WELLBEING, AND ALSO LOOK AT, UH, WHAT COSTS CAN BE COVERED BY OTHER FUNDING STREAMS. THIS COULD BE SERVICES, UH, CLINICAL SERVICES OR COMMUNITY MENTAL HEALTH SERVICES, LIKE COMPREHENSIVE COMMUNITY SERVICES OR CHILDREN'S LONG-TERM SUPPORT. 
          UM, AND IT'S REALLY MEANT TO SUPPORT, UM, FAMILY FUNCTIONING AND IMPROVE THE FUNCTIONING OF FAMILY WITHIN, WITHIN OUR SYSTEMS. AND WHAT WE'RE, WHAT WE'VE DECIDED TO DO TO MEET THIS GOAL IS, UM, WE HAVE APPLIED FOR DCF, UM, FOR A PROGRAM OR A CHARTER CALLED PDSA. 
          AND THIS GUIDED PROCESS IS GONNA BRING US THROUGH, UM, A REVIEW ANALYSIS OF OUR COMMUNICATION, AN INTERNAL PROCESS FOR REFERRAL, OUR INTERNAL COMMUNICATION, UM, HOW, UM, HOW SERVICES ARE BEING FUNDED, SPECIFICALLY CHILD WELFARE AND BEHAVIORAL HEALTH. 
          AND WE, HOW WE CAN SHARE SOME FUNDING STREAMS. UM, RIGHT NOW, THAT PROGRAM RUNS FROM SEPTEMBER OF THIS YEAR THROUGH, ACTUALLY THROUGH MAY OF 2025. 
          AND THERE ARE EIGHT REPRESENTATIVES BETWEEN CHILDREN AND FAMILIES, UH, AND MY PARTNERS IN THE BEHAVIORAL HEALTH DIVISION, UH, INCLUDING MYSELF AND THE, THE BEHAVIORAL HEALTH MANAGER, DOUG BRI. 
          SO WE WILL KNOW BY THE END OF THIS MONTH IF WE'VE BEEN ACCEPTED FOR, FOR THIS PROGRAM. 
          I'M, I'M FAIRLY CERTAIN WE, WE WILL BE, AND IT'S GONNA BE REALLY GREAT FOR US TO BE ABLE TO DO A GUIDED PROCESS TO, TO HELP US MEET OUR GOAL. 
          SO I LOOK FORWARD TO REPORTING MORE ON THAT AS WE GET STARTED. 
          GREAT. 
          THE SECOND ONE, UM, IS ANALYZING THE STRUCTURE AND SUSTAINABILITY OF FAMILY COURT SERVICES. 
          AND YOU JUST HEARD ME SAY A LITTLE BIT ABOUT THAT, THAT I HAVE ONE FULL-TIME EQUIVALENT, UM, SENIOR SOCIAL WORKER DOING FAMILY COURT CUSTODY, UH, EVALUATIONS. 
          SO FAMILY COURT SERVICES IS MANDATED UNDER WISCONSIN STATUTE 7, 6 7, AND IS CURRENTLY STRUCTURED AS A PARTNERSHIP BETWEEN FAMILY COURT SERVICES, THE COURT, AND ALSO THE HUMAN SERVICES DEPARTMENT. 
          UM, RIGHT NOW WE ARE TAKING A LOOK AT OUR, LIKE SIZED, IF YOU WILL, OUR LIKE SIZED COUNTIES, UM, AT HOW THEY, THEY HAVE STRUCTURED THEIR FAMILY, THEIR FAMILY COURT SERVICES. 
          IT IS NOT MANDATED THAT HUMAN SERVICES ACTUALLY PROVIDE THE CUSTODY STUDIES OR PROVIDE THE WORKERS TO DO THE ACTUAL WORK FOR THE REPORTS AND THE EVALUATIONS. 
          AND SO REALLY WITH THE INCREASED CASELOADS AND INCREASED COMPLEXITY OF OUR JUVENILES COMING IN, LOOKING AT IF THIS PARTICULAR PROGRAM CONTINUES TO BE A GOOD FIT WITHIN THE HUMAN SERVICES DEPARTMENT. 
          SO WE'RE REVIEWING, UH, RESEARCHING AND REVIEWING FAMILY COURT SERVICE MODELS WITHIN OUR REGION. 
          UH, WAUKESHA, SHEBOYGAN, FOND DULAC, OZAKI DODGE, AND JEFFERSON. 
          AND WE'RE PUTTING TOGETHER AN ANALYSIS OF HOW THOSE COUNTIES STRUCTURE THEIR SERVICES, HOW WE'RE CURRENTLY STRUCTURED, AND REALLY LOOKING AT THE IMPACT OF, UM, WORKER COST, WORKER TIME, THE, THE COSTS ON THE STUDIES. 
          THERE'S AN UPFRONT FEE ABOUT $2,400 FOR WORKER TO DO THE STUDY. 
          AND THEN THEY BILL HOURLY, UH, THEY BILL HOURLY, UM, THROUGH TRIAL AND THROUGH, UM, ACTUALLY WRITING A REPORT. 
          SO IT'S QUITE COSTLY TO FAMILIES. 
          WE'RE ALSO JUST TRYING TO FIGURE OUT HOW THAT FITS WITHIN, UH, WITHIN THE CHILDREN AND FAMILIES DIVISION. 
          SO I LOOK FORWARD ON REPORTING, UH, ON THAT AS WELL. 
          I THINK IT'LL BE INTERESTING TO SEE, UM, HOW WE FIT WITH OUR, WITH OUR LIKE SIZED COUNTIES. 
          AND HOW OTHER FAMILY COURT SERVICES, UM, OPERATE IN SOUTHEASTERN WISCONSIN. 
          YES. 
          CORAL, I JUST HAVE A QUESTION, UM, AS TO, I KNOW YOU HAVE THE INITIATIVE OUTLINED IN, YOU KNOW, VERBIAGE OF COURSE, BUT CAN YOU TELL US WHAT WAS THE IMPETUS TO USE THIS AS AN INITIATIVE AND TO, UM, ARE THERE, IS IT, IS IT S ARE YOU, IS THE EMPHASIS ON THE SUSTAINABILITY PIECE OR, YOU KNOW, WHAT, WHAT WAS THE REASON FOR ? YEAH. 
          THE, THE REASON FOR BRINGING THIS INITIATIVE FORWARD IS, LIKE I SAID, WE'VE GOT, WE'VE GOT ONE FULL FTE ALLOCATED FOR THAT. 
          THERE IS NO ADDITIONAL FUNDING FROM COMING FROM THE COURT TO SUPPORT THESE POSITIONS. 
          MM-HMM. 
          , IT HAS ALWAYS BEEN, THE 
          [00:15:01]
STATUTE IN MY UNDERSTANDING, HAS ALWAYS BEEN INTERPRETED THAT THIS PARTICULAR POSITION WILL BE HOUSED WITHIN, WITHIN THE HUMAN SERVICES DEPARTMENT. 
          UM, AND WITH, HONESTLY WITH THE NEEDS OF OUR JUVENILE CASELOADS AND THOSE FAMILIES, UM, THAT ONE OTHER POSITION WOULD BE, COULD POSSIBLY BE BETTER SERVED DOING A JUVENILE WORK. 
          UM, NOT THAT IT'S NOT A GREAT SERVICE TO THE FAMILY COURT, BUT WE'RE LOOKING TO SEE SUSTAINABILITY, WHAT THAT LOOKS LIKE. 
          OKAY. 
          YEAH. 
          SUPERVISOR BOSER. 
          YEP. 
          SO, UM, OBVIOUSLY I HAVE A LOT OF EXPERIENCE IN THE FAMILY COURT ISSUES. 
          , I HEARING THAT, MY INITIAL THOUGHT IS PHILOSOPHICALLY I LIKE SOMEBODY OUTSIDE THE COURT SYSTEM BEING INVOLVED IN THE PLACEMENT REVIEW. 
          MM-HMM. 
          . 
          UM, I CAN KIND OF MAYBE AFTER THE MEETING SHARE WITH YOU SOME THOUGHTS ON WHY I FEEL THAT WAY. 
          UM, THAT DOESN'T MEAN I'M NECESSARILY AGAINST CHANGES, BUT, BUT I HAVE SOME THOUGHTS I COULD SHARE WITH YOU ON THAT OFFLINE. 
          THANK YOU. 
          YEAH, I APPRECIATE THAT. 
          AND I WOULD SAY IT'S NOT THAT SOMEONE THAT, THAT THOSE EVALUATIONS WOULDN'T HAPPEN WHO ARE OUTSIDE THE COURT. 
          IT'S JUST DOES THAT SERVICE BELONG WITHIN THE HUMAN SERVICES DEPARTMENT? BECAUSE WE HAVE, WE HAVE A LOT OF CROSS SYSTEM CLIENTS, PEOPLE COMING ACROSS THE STREET INTO SOCIAL SERVICES, INTO CHILDREN AND FAMILIES WHO MAYBE HAVE RECEIVED OTHER SERVICES THERE AND ARE NOT GOING THROUGH A DIVORCE OR A CUSTODY STUDY. 
          AND WHAT DOES THAT MEAN FOR THAT FAMILY WALKING IN THOSE DOORS, RECEIVING A COMPLETELY DIFFERENT TYPE OF SERVICE SO THAT, THAT SERVICE, THAT PARTICULAR STRUCTURE OF HOW THOSE TWO PIECES WORK, THE COURT PIECE AND THE CUSTODY PIECE, UM, THOSE ARE MANDATED TO, TO OCCUR. 
          SO YEAH. 
          YEAH. 
          I APPRECIATE THAT. 
          YEP. 
          ALL RIGHT. 
          THANK YOU. 
          YOU'RE WELCOME. 
          OKAY. 
          JULIE, DID YOU HAVE SOMETHING TO ADD OR I GOOD. 
          I DON'T THINK AT THIS TIME, NO. 
          OKAY. 
          THANKS. 
          OKAY. 
          SUPERVISOR GALLES. 
          YEAH. 
          CHAIR. 
          SO, SO NOT, I KNOW WE'RE NOT SUPPOSED TO GET IN THE SAUSAGE MAKING, UH, OF THE EOS SURE. 
          UH, COMPONENT, RIGHT. 
          BEING NEW TO THIS, UM, WHAT ARE YOU, WHAT ARE YOUR INITIAL FINDINGS OR, UH, IS IT PREMATURE? UM, BECAUSE THIS IS DETERMINED A SUSTAINABILITY PLAN, HOW IT COMPARES THE OTHER COUNTIES. 
          SO ARE WE, YOU KNOW, ON PAR, WE PLUS MINUS? IT'S SLIGHTLY PREMATURE. 
          HOWEVER, I WOULD SAY WE ARE UNIQUE IN OUR STRUCTURE. 
          HMM. 
          OKAY. 
          THAT ANSWER YOUR QUESTION, SUPERVISOR GALLES? IT IS. 
          I'LL, I'LL WAIT TO UNDERSTAND. 
          UNIQUE WHEN THE TIME COMES. 
          . 
          OKAY. 
           SOUNDS LIKE A PLAN. 
          . 
          ALL RIGHT. 
          THANK YOU, YOU SO MUCH. 
          YOU VERY MUCH. 
          CARL. 
          OUR 
          [c. Washington Ozaukee Health Department Childhood Lead Poisoning Prevention Program]
NEXT ITEM IS THE WASHINGTON OZAKI HEALTH DEPARTMENT CHILDHOOD LEAD POISONING PREVENTION PROGRAM. 
          SAY THAT FAST THREE TIMES. 
          THANK YOU, JOEY. 
          WELCOME, KIM. 
          UM, HI. 
          FOR THOSE OF YOU WHO HAVEN'T MET ME YET, I'M KIM BECHLER. 
          I'M THE DIRECTOR OF THE WASHINGTON OZAKI PUBLIC HEALTH DEPARTMENT. 
          I'M HERE TO GIVE YOU, UM, A LEAD UPDATE. 
          WE HAVE, UM, FOR THOSE OF YOU WHO ARE NEWER TO THE COMMITTEE, WE HAVE BEEN WORKING ON A CHILDHOOD LEAD POISONING PREVENTION CAMPAIGN. 
          UM, IT WAS OFFICIALLY LAUNCHED IN JANUARY. 
          THIS IS IN PARTNERSHIP WITH EPIC CREATIVE IN WASHINGTON COUNTY. 
          UM, AND THIS, THE INITIATIVE IS REALLY TO, UM, KIND OF DO A TWO PART, UM, IMPROVEMENT, I GUESS, IF YOU WILL, IN WASHINGTON AND OZAKI COUNTIES. 
          ONE OF OUR GOALS OVERALL IS TO INCREASE THE AMOUNT OF CHILDREN WHO ARE BEING TESTED FOR CHILDHOOD LED POISONING. 
          AND THAT TYPICALLY IS SUPPOSED TO HAPPEN AROUND THE AGES OF ONE AND TWO. 
          AND IF IT DOESN'T HAPPEN AT THOSE AGES, AT LEAST SOMETIME BETWEEN THE AGES OF ONE AND SIX. 
          UM, SO WE'RE LOOKING TO INCREASE THE NUMBER OF CHILDREN THAT ARE TESTED. 
          AND THEN IN ADDITION TO THAT, OBVIOUSLY THE NEXT PART OF THAT IS THAT WE ARE HOPING TO ALSO DO SOME PREVENTATIVE WORK EDUCATION TO THE COMMUNITY, UM, ON THE DANGERS OF LEAD, THE SOURCES OF LEAD EXPOSURE TO CHILDREN, AND THEN HOPEFULLY OVER A PERIOD OF LONGER TERM, UM, REDUCE THE NUMBER OF CHILDREN THAT ARE COMING BACK WITH HIGH LEAD LEVELS IN OUR COUNTIES. 
          SO I JUST WANNA GIVE YOU A LITTLE BACKGROUND INFO ON WHAT OUR PROGRAM DOES, JUST FOR THOSE OF YOU WHO, UM, HAVEN'T BEEN HERE THE LAST FEW MONTHS THAT I'VE TALKED ABOUT THIS. 
          AND THEN KIND OF AN UPDATE ON SOME OF THE DATA THAT WE'RE STARTING TO SEE. 
          AND THEN NEXT STEPS THAT WE'RE PLANNING FOR THIS, THE SHORT TERM FUTURE. 
          UM, SO GENERALLY SPEAKING, OUR DEPARTMENT, OUR WIC STAFF, UM, PROVIDE LEAD TESTS TO THOSE WHO ARE ACTUALLY, UM, CHILDREN IN OUR LEAD IN OUR WIC PROGRAM. 
          BUT WE DON'T TYPICALLY PROVIDE CHILDHOOD LEAD TESTING TO THOSE WHO ARE NOT WITHIN WIC. 
          SO WE RELY ON, UM, PEDIATRICIANS AND, UM, OTHER SOURCES OUTSIDE OF OUR DEPARTMENT, WHETHER THAT'S SOME KIND OF CLINIC, UM, TO PROVIDE THOSE TESTS TO CHILDREN. 
          [00:20:01]
AND WE'VE FOUND IN THE PAST THAT IT'S VERY INCONSISTENT. 
          IT'S TYPICALLY UP TO THE PROVIDER THEMSELVES TO DECIDE HOW AND WHEN THEY OFFER LEAD TESTS TO CHILDREN. 
          SO SOME ARE REALLY GOOD ABOUT JUST OFFERING IT TO EVERY CHILD AT A SPECIFIC AGE. 
          SOME, UM, PEDIATRICIANS WILL OFFER IT TO CHILDREN THAT THEY'VE DEEMED TO BE HIGHER RISK. 
          AND THEN OTHERS, IT MAYBE THEY'RE NOT REALLY BROACHING THE SUBJECT AT ALL UNLESS A PARENT ASKS FOR IT. 
          SO ONE COMPONENT OF OUR CAMPAIGN HAS ACTUALLY BEEN OUTREACH TO THOSE PROVIDERS TO MAKE SURE THAT THEY ARE AWARE OF THE IMPORTANCE OF REGULAR TESTING FOR ALL CHILDREN. 
          UM, AND IN ADDITION TO THAT, WE HAVE OPENED UP OUR CLINIC TO THE PUBLIC, AT LEAST FOR THE TIME BEING, TO PROVIDE LEAD TESTING TO ANYBODY WHO IS INTERESTED IN GETTING ONE, WHETHER THEY'RE ON OUR WIC PROGRAM OR NOT. 
          SO, UM, FOR THOSE OF YOU WHO ARE NOT FAMILIAR WITH THE CHILDHOOD LED TESTING PROGRAM, WE DO TEST CHILDREN WITH, ORIGINALLY WITH A FINGER POKE. 
          AND IF THEIR CHILDHOOD LED TEST COMES BACK AT, UM, A HIGHER LEVEL THAN 3.5 MICROGRAMS PER DECILITER, WE WOULD RETEST THEM. 
          UM, IF IT'S UNDERNEATH THAT POINT, WE CALL IT GOOD. 
          WE RETEST AGAIN AT THE AGE TWO IF IT WAS AT AGE ONE. 
          UM, BUT IF IT'S HIGHER THAN THAT, WE WILL DO CASE MANAGEMENT AND TRY TO WORK WITH THE PARENTS TO IDENTIFY SOURCES OF LEAD EXPOSURE, REDUCE THE SOURCES OF LEAD EXPOSURE, AND THEN TEST THEM AGAIN. 
          UM, IT'S ACTUALLY STATE, STATE REQUIRED IS THAT WE TEST THEM UNDER, SO THEY GET THE UNDER TO THE LEVEL OF UNDER FIVE C, DC RECOMMENDATIONS IS 3.5. 
          SO WE AS A DEPARTMENT, HAVE CHOSEN TO START TESTING TO KEEP, KEEP THEM UNDER THE LEVEL OF 3.5, KNOWING THAT EVENTUALLY THE STATE WILL PROBABLY FOLLOW SUIT AND REDUCE THAT LIMIT AS WELL. 
          SO WE'RE KIND OF A LITTLE BIT PROACTIVE WITH THAT. 
          BUT IT IS IMPORTANT TO US THAT WE'RE CATCHING THOSE CHILDREN BEFORE THEY HIT THAT LEVEL OF FIVE. 
          UM, AFTER THAT POINT, IF THEY ARE AT A HIGHER LEAD LEVEL FOR AN EXTENDED PERIOD OF TIME, WE WOULD EVENTUALLY, POTENTIALLY GO INTO THEIR HOME IF THAT LEAD LEVEL IS HIGHER THAN 15 MICROGRAMS PER DECILITER. 
          AND THAT'S WHEN WE WOULD TEST FOR VARIOUS SOURCES WITHIN THE HOME, WHETHER THAT'S, UM, YOU KNOW, IF THEY'RE DOING CONSTRUCTION, WE WOULD DO TESTING THEIR WINDOWS, THEIR FLOORS, UM, IF THEY'VE GOT DUST, WE WOULD LOOK AT ALL OF THOSE POTENTIAL SOURCES AND THEN TALK WITH PARENTS ABOUT ANY OTHER SOURCES OF LEAD EXPOSURE IF THERE'S NOT SOMETHING WE CAN IDENTIFY UNIQUELY TO THAT HOME. 
          SO THAT ASIDE, UM, SO FAR WHAT WE HAVE DONE FOR THIS CAMPAIGN IS THAT WE SENT OUT THAT LETTER TO PROVIDERS. 
          ORIGINALLY, WE'VE SENT OUT PRESS RELEASES TO NOTIFY THE PUBLIC THAT WE ARE LAUNCHING THIS CAMPAIGN. 
          WE, UM, OFFICIALLY LAUNCHED IN JANUARY. 
          WE HAVE A LIVE WEBSITE THAT'S SPECIFICALLY TARGETED TO THIS CAMPAIGN. 
          IT'S CALLED GET TESTED FOR LEAD.COM WITH A LANDING PAGE THAT ACTUALLY ALLOWS, UM, PARENTS TO SIGN UP FOR OUR CLINICS RIGHT OFF OF THE WEBSITE AS WELL. 
          AND THEN, UM, WE HAVE ALSO ADDED THOSE IN-HOUSE TESTING CLINICS IN BOTH OF OUR OFFICES TO MAKE IT EASIER FOR PARENTS TO GET TESTED, EVEN IF THEY CAN'T GET INTO THEIR PROVIDER'S OFFICE. 
          'CAUSE A LOT OF TIMES THEY'RE BOOKED OUT AND IT JUST DOESN'T HAPPEN. 
          UM, SO BECAUSE WE ARE JUST PAST QUARTER ONE, I'VE GOT SOME KIND OF EXCITING STATS TO SHARE WITH ALL OF YOU TODAY. 
          JUST TO KIND OF GIVE YOU AN IDEA OF THE REACH THAT WE'VE BEEN ABLE TO GET, UM, JUST THROUGH QUARTER ONE OF 2024. 
          THIS IS, UM, STATISTICS THAT WE RECEIVED THROUGH EPIC. 
          UM, SO WE HAD A VARIETY OF DIFFERENT ADVERTISEMENTS THAT WE PUT OUT TO THE PUBLIC. 
          WE REALLY WANTED TO MAKE SURE THAT WE HAD A WELL-ROUNDED CAMPAIGN AND THAT WE'RE REACHING INDIVIDUALS REGARDLESS OF WHAT THEY ARE PAYING ATTENTION TO. 
          SO, UM, JUST TO GIVE YOU A LITTLE BIT OF A WELL-ROUNDED IDEA, WE HAVE IN QUARTER ONE REACHED 270 1073 PEOPLE VIA SOCIAL MEDIA. 
          42,471 PEOPLE JUST THROUGH YOUTUBE, TWO HUNDRED AND NINE, SIX HUNDRED AND NINETY, TWO HUNDRED 9,000, SORRY, 697 THROUGH TV COMMERCIAL VIEWS. 
          AND THEN THE CAMPAIGN WAS ALSO PICKED UP BY NUMEROUS LOCAL NEWSPAPERS, WHICH IS EXCITING BECAUSE THEY WANNA HELP US ADVERTISE TO THOSE WHO ARE NOT UTILIZING THE SOCIAL MEDIA. 
          UM, WITH THAT, I THOUGHT AN INTERESTING PIECE OF THIS DATA WAS THAT OUR 15 SECOND TARGETED ADVERTISEMENT THAT WAS, UM, REVOLVING AROUND A PARENT DAYCARE SITUATION WAS THE MOST, MOST WATCHED VIDEO ON ALL OF OUR VARIOUS SOURCES OF ADVERTISING. 
          UM, AND THAT'S INTERESTING TO US BECAUSE WE ARE ALSO PLANNING TO START A NEW PARTNERSHIP WITH SOME OF OUR CHILDCARE FACILITIES, WHICH I WILL GET TO IN JUST A COUPLE OF MINUTES. 
          UM, INTERNALLY, WE'VE ALSO STARTED NOTICING SOME TRENDS WITH OUR NURSING DEPARTMENT AND OUR WIC DEPARTMENT. 
          UM, THERE ARE TWO DATA SOURCES THAT WE CAN LOOK AT TO IDENTIFY WHO IS ACTUALLY BEING TESTED AND WHAT THOSE TESTING RESULTS ARE COMING IN AT. 
          SO OUR HEALTHY HOMES AND LEAD POISONING 
          [00:25:01]
SURVEILLANCE SYSTEM, OTHERWISE KNOWN AS HELPS, UM, GIVES US DATA FOR CHILDREN THAT ARE ON MEDICAID, SPECIFICALLY FROM JANUARY THROUGH MAY OF TWENTY TWENTY FOUR, FIVE HUNDRED AND NINETY NINE. 
          NEW SCREENINGS FOR LEAD WERE COMPLETED COMPARED TO THE SAME TIME PERIOD IN 2023, WHICH ONLY SAW 411 CHILDREN ON MEDICAID. 
          SO THAT'S A VERY SIGNIFICANT INCREASE. 
          UM, CAN YOU REPEAT THOSE NUMBERS? YES. 
          THIS YEAR, JANUARY THROUGH MAY 599, LAST YEAR, 411, PRIOR TO COVID, THERE WERE, UM, FOR COMPARISON'S SAKE, IN 2017 THERE WERE 488. 
          IN 27 IN 2018, THERE WERE 493. 
          SO BETWEEN FOUR AND 500 IS TYPICAL, UM, PRE AND POST COVID, WHEREAS WE ARE AT 599 FOR THIS YEAR. 
          SO FAR OUTSIDE OF MEDICAID, TOTAL NUMBERS THAT WE CAN PULL FROM WISCONSIN IMMUNIZATIONS REGISTRY JANUARY THROUGH MAY, THAT SAME SPECIFIC TARGETED DATE RANGE. 
          LAST YEAR WE SAW 467 CHILDREN TOTAL IN OUR COUNTIES. 
          AND THIS YEAR WE HAVE SEEN 763 TESTED. 
          SO WE CAN KIND OF TELL THAT IF THIS DATA TREND CONTINUES, WE CAN ATTRIBUTE THIS PARTIALLY TO A, A LITTLE BIT OF AN INCREASE BACK TO NORMAL OF TESTING PRE COVID, I, YOU KNOW, PEOPLE WERE TAKING THEIR KIDS TO THE HOSPITAL OR THE DOCTOR MORE OFTEN, THEY WERE GETTING THEIR REGULAR TESTING DONE. 
          UM, WE KNOW THERE WAS A DROP WITH COD, SO WE EXPECTED A LITTLE BIT OF A SPIKE, BUT WE CAN ALSO, UM, I THINK IT'S FAIR TO SAY, ATTRIBUTE SOME OF IT TO OUR CAMPAIGN AND THE EDUCATION THAT WE'VE PUT OUT THERE JUST BECAUSE IT IS SUCH A SIGNIFICANT SPIKE ALREADY. 
          SO WE ARE HOPEFUL THAT THAT CONTINUES TO INCREASE AS WE GO THROUGH THE REST OF THE YEAR. 
          AND THEN CLOSER TO THE END OF THE YEAR, WE ARE ALSO HOPING TO SEE A LITTLE BIT MORE DATA ON ACTUAL, UM, RESULTS OF THOSE TESTS. 
          THEN HOPEFULLY WE WILL SEE A DECLINE IN ACTUAL HIGH LEAD LEVELS. 
          AND THOUGH FOR THOSE OF YOU WHO HAVE NOT BEEN IN THIS CONVERSATION FOR LONG, UM, WE DO NOT TYPICALLY SEE A LOT OF HIGH LEAD LEVELS IN WASHINGTON OR OZAKI COUNTIES. 
          THIS IS NOT AN EXTREME ISSUE RIGHT NOW. 
          WE ARE VERY MUCH TRYING TO BE PREVENTATIVE. 
          IT IS A WELL-KNOWN ISSUE ACROSS THE STATE OF WISCONSIN. 
          IT'S NOT NEW. 
          IT'S BEEN GOING ON FOR A LONG TIME. 
          UH, THIS IS NOT EVEN THE FIRST LEAD CAMPAIGN OUR HEALTH DEPARTMENT HAS DONE. 
          THERE'S PLENTY OF 'EM IN THE PAST. 
          UM, BUT WE DO KNOW THAT THERE ARE SOME GREAT OPPORTUNITIES RIGHT NOW FOR JUST BEING PROACTIVE BECAUSE THIS IS A VERY PREVENTABLE PREVENTATIVE ISSUE WITH CHILDREN. 
          SO WE'RE TRYING TO GET AHEAD OF IT WHILE WE CAN AND WHILE WE HAVE THE FUNDING TO DO SO. 
          UM, WHAT'S NEXT FOR OUR DEPARTMENT? WE ARE IN THE WORKS OF PARTNERING WITH DHS ON AN EXCITING OPPORTUNITY FOR TESTING CHILDHOOD LED LEVELS IN WATER, SPECIFICALLY FOR CHILDCARE FACILITIES. 
          SO IT'S CALLED THE CHILDCARE LED IN WATER TESTING PROGRAM. 
          I'M TAKING IT TO THE OZAKI COUNTY HUMAN SERVICES COMMITTEE NEXT WEEK FOR FORMAL APPROVAL TO ADD IT INTO OUR BUDGET FOR THIS YEAR BECAUSE IT IS TECHNICALLY A GRANT. 
          UM, BUT THE GOAL OF THIS PROGRAM IS TO GET AT LEAST 50% PARTICIPATION OF CHILDCARE FACILITIES THAT ARE LICENSED IN WASHINGTON AND OZAKI COUNTIES. 
          WE HAVE 82 OF THEM BETWEEN THE TWO COUNTIES, SO WE'RE HOPING TO GET 41 ON BOARD. 
          WE TALKED WITH DHS, WE WERE ABLE TO SET OUR OWN GOAL. 
          UM, OTHER COUNTIES THAT HAVE PARTICIPATED IN THIS, THEY'VE HAD A VERY WIDE RANGE OF PARTICIPATION. 
          SO THIS IS JUST US PICKING A NUMBER AND SEEING WHAT WE CAN DO. 
          UM, BUT THEY WILL REIMBURSE US $1,200 PER FACILITY TO GO IN. 
          OUR STAFF WILL DO THE TESTING FOR THEIR WATER SPECIFICALLY AT EACH OF THESE LICENSED FACILITIES, AND THEN WORK WITH THE PARENTS AND PROVIDERS AT THE FACILITIES ON EDUCATING THEM ABOUT THE DANGERS OF LEAD POISONING. 
          AND THEN IF THAT FACILITY COMES BACK WITH A HIGH LEAD LEVEL, THE STATE WILL ACTUALLY PAY TO HELP THEM REMEDIATE THE ISSUE. 
          AND I DON'T THINK THIS IS SOMETHING THAT'S GOING AWAY. 
          I THINK THEY'LL PROBABLY BE REQUIRED TO ACT ON THIS IN THE FUTURE. 
          SO IT'S A REALLY GOOD OPPORTUNITY FOR THEM TO TAKE ADVANTAGE OF IT NOW. 
          SO WE ARE IN THE PROCESS OF PUTTING TOGETHER, UM, OUR PLAN OF ATTACK FOR GETTING THEM ALL TO SIGN ON BOARD FOR THAT. 
          UM, BUT OF COURSE, AS I STATED EARLIER, THIS IS ALL PENDING APPROVAL FOR ZAKI COUNTY TO ADD IT INTO OUR BUDGET AS WELL. 
          AND THEN FOLLOWING THAT, IF THERE ARE, UM, FACILITIES THAT COME BACK WITH HIGH LEVELS, WE ARE HOPEFUL THAT WE WOULD BE ABLE TO PARTNER WITH THEM TO HAVE FURTHER LEAD TESTING CLINICS FOR THOSE CHILDREN IN THAT FACILITY. 
          WE WOULD SEND OUR NURSING STAFF TO DO THOSE LEAD TESTS RIGHT THERE AT THE FACILITY IF PARENTS SO CHOOSE TO PARTICIPATE. 
          ANY QUESTIONS ON ANY OF THAT? ANY QUESTIONS, SUPERVISOR BUZZER? YEP. 
          SO YOU TALK ABOUT THE LEAD EXPOSURE CASES AND GOING INTO HOMES AND FINDING CAUSES. 
          MM-HMM. 
          , UH, RIGHT NOW WE'RE INVESTING A LOT OF MONEY TO PARTNER WITH THE CITY OF WEST BEND TO REPLACE LEAD LATERALS 
          [00:30:01]
GOING INTO HOMES FOR THE WATER LINES. 
          MM-HMM. 
          , WHEN YOU DO THOSE CASE STUDIES, IS THAT A ITEM THAT FREQUENTLY IS A SOURCE OF LEAD EXPOSURE? IN OUR COUNTIES? NO. 
          TYPICALLY THE MOST LEAD EXPOSURE THAT WE SEE VERY MUCH IN WASHINGTON COUNTY ESPECIALLY, IS THOSE OLDER HOMES THAT ARE BEING REMODELED BECAUSE THEY'RE GETTING INTO THE WALLS, THEY'RE GETTING INTO THE DUST, THEY'RE KICKING UP ALL OF THAT STUFF THAT'S BEEN KIND OF COVERED UP FOR YEARS. 
          UM, AND THERE'S TYPICALLY SOURCES OF LEAD IN, YOU KNOW, THE PAINT AND ALL OF THAT. 
          UM, LEAD LATERALS CAN CERTAINLY BE AN ISSUE, BUT IT'S NOT A KNOWN SOURCE OF, UM, CHILDHOOD LED POISONING IN OUR COUNTY RIGHT NOW. 
          OKAY. 
          SOUNDS GOOD. 
          AND THEN WHAT PERCENTAGE OF KIDS WHEN YOU DO THESE TESTS ARE TESTING POSITIVE? I DON'T HAVE A SPECIFIC PERCENTAGE. 
          I MEAN, IT FLUCTUATES A LITTLE BIT. 
          I CAN GIVE YOU SOME MORE STATS ON HOW MANY WE'RE ACTUALLY SEEING. 
          UM, MAYBE AT MY NEXT UPDATE, IT'LL BE KIND OF LIKE A MID-YEAR UPDATE. 
          I CAN GIVE YOU SOME STATS ON LIKE 5%, 2%. 
          YEAH, IT'S VERY LOW. 
          YEAH. 
          YEAH. 
          YEAH. 
          OKAY. 
          SOUNDS GOOD. 
          THANK YOU. 
          SURE. 
          THANK YOU, KIM. 
          ANY OTHER QUESTIONS FOR HER ALL? JULIE, IF I COULD JUST ADD, UM, SO I JUST WANNA SAY, YOU KNOW, THANKS SO MUCH TO KIM AND, AND THE PUBLIC HEALTH DEPARTMENT FOR TAKING ON THIS, UM, THIS CAMPAIGN, UM, TO COINCIDE WITH THE, THE WORK AND THE EFFORTS OF THE COUNTY BOARD ON REPLACING LEAD LATERALS. 
          UM, BECAUSE OBVIOUSLY THE PUBLIC HEALTH EDUCATION AND TESTING IS, IS A HUGE PART OF, OF THE WHOLE PUZZLE. 
          UM, BUT I WOULD SAY, AND ESPECIALLY TO, UH, YOUR COMMENT SUPERVISOR BOSER, THE, UM, THE LEAD LATERAL ISSUES ARE REALLY RIGHT NOW FOR WASHINGTON COUNTY, A PREVENTATIVE STANDPOINT. 
          AND SO THAT WE'RE NOT, UM, DOWN THE ROAD 10, 15, 20 YEARS IN A CRISIS MODE WHERE WE'RE HAVING SIGNIFICANT EXPOSURE. 
          AND SO ESSENTIALLY WE'RE, WE'RE DOING THE WORK FOR FUTURE CHILDREN. 
          YEP. 
          GOTCHA. 
          THANK YOU. 
          THANK YOU. 
          THANK YOU, KIM. 
          MM-HMM, . 
          ALL RIGHT. 
          UH, OUR NEXT ITEM 
          [d. Opioid Settlement Update]
IS THE OPIOID SETTLEMENT UPDATE. 
          UM, JULIE WILL COVER THINGS. 
          SO COOL. 
          TAKE IT AWAY. 
          THANK YOU. 
          SO, UM, SO FOR THOSE OF YOU WHO DON'T KNOW ME, I'M JULIE DRISCOLL, I'M THE CHIEF HEALTH AND HUMAN SERVICES OFFICER FOR WASHINGTON COUNTY. 
          UM, SO IN YOUR PACKET IS, UM, A SPREADSHEET, UM, MAYBE HARD TO READ, MAYBE HARD TO FOLLOW, UM, A LITTLE BIT HARD TO FOLLOW FOR OURSELVES. 
          SO, UM, AS YOU MAY BE AWARE, WASHINGTON COUNTY, UM, SIGNED ONTO THE OPIOID SETTLEMENT AGREEMENT, UM, A NUMBER OF YEARS AGO. 
          AND, UM, WE HAVE RECEIVED SOME INITIAL FUNDING, UM, THAT THE COUNTY BOARD HAS GIVEN, UH, APPROVAL, UM, TO SPEND A MILLION DOLLARS OF OUR OPIOID SETTLEMENT DOLLARS, UM, ON A RECOVERY HOUSE, WHICH WE'LL TALK ABOUT IN THE NEXT AGENDA ITEM. 
          BUT I WANTED TO GIVE, UM, THIS COMMITTEE A SENSE OF WHERE WE STAND TODAY, UM, ON MONIES THAT WE'VE RECEIVED, AND ALSO WHAT OUR BEST ESTIMATE OF FUTURE FUNDS. 
          SO SINCE THE INITIAL SETTLEMENT, UM, YOU'VE HAD, UH, ADDITIONAL MANUFACTURERS AND PHARMACIES SETTLE AS WELL. 
          AND SO THERE'S ADDITIONAL MONEY THAT WILL BE COMING INTO WASHINGTON COUNTY. 
          UM, YOU CAN SEE IN THE BOX BELOW THE, UM, THE NUMBERS DATA, UM, THAT PER THE MOU FOR THE SETTLEMENT, UM, 30% GOES TO THE STATE AND 70% GOES TO LOCAL GOVERNMENT. 
          AND WASHINGTON COUNTY WILL GET 1.99% OF THE LOCAL GOVERNMENT SHARE SOME OF THOSE DOLLARS AS THEY CONTINUE TO SETTLE. 
          UM, SOME OF THESE LAWSUITS ARE STILL UNKNOWN, AND THEN THE ACTUAL DISBURSEMENT IS NOT, UM, AS CLEAR AS, AS I WOULD LIKE IT TO BE. 
          UM, BUT I WANTED TO JUST MAKE SURE THAT THIS COMMITTEE, UM, WAS AWARE OF WHERE WE STAND TODAY. 
          SO WE HAVE RECEIVED, UM, 1.1 8 5, 1 0.1 MILLION, $185,649. 
          BUT IN 2024, YOU CAN SEE, UM, SOME DOLLAR AMOUNTS THAT WE ARE ANTICIPATING RECEIVING, UM, THE PHARMACY PAYMENT SPECIFICALLY, UM, WHICH IS $753,531. 
          THEY ARE MAKING A SEVEN YEAR PAYMENT TO US. 
          SO THEY'RE PAYING IN ADVANCE. 
          AND THAT IS NOT SOMETHING THAT WE ANTICIPATED. 
          UM, AND SO THIS IS SORT OF HOW THIS IS GOING, RIGHT? WE'RE GETTING SOME DOLLARS, UM, AHEAD OF TIME THAT WE'RE NOT ANTICIPATING. 
          AND SO IT'S HARD FOR US TO PLAN, UM, FOR THOSE DOLLARS. 
          UM, WE'RE GOING TO GET ADDITIONAL, YOU SORT OF, IF YOU GO YEAR TO YEAR THROUGH MANUFACTURERS AND THE PHARMACIES, WE'RE GOING TO GET ADDITIONAL DOLLARS, UM, EVERY YEAR FOR CONTINUED PAYMENT. 
          UM, BUT WE DON'T EXACTLY KNOW WHAT THAT DOLLAR AMOUNT IS. 
          UM, WISCONSIN COUNTY ASSOCIATION IS TRYING TO HELP COUNTIES TO DO SOME PROJECTIONS, BUT WE'RE WAITING FOR THAT INFORMATION. 
          UM, BUT AT THE END OF THIS 
          [00:35:01]
YEAR, WE ANTICIPATE HAVING ABOUT $2.3 MILLION RECEIVED FROM THE OPIOID SETTLEMENT WITH A MILLION DOLLARS ALREADY EARMARKED FOR, UH, RECOVERY HOUSING. 
          SO WANTED TO BE VERY TRANSPARENT WITH THIS COMMITTEE ABOUT WHERE WE STAND, BUT ALSO WANTED, UM, YOU TO BE AWARE THAT AT THIS POINT WE HAVE NO, UM, NO PROPOSAL TO BRING FORWARD TO YOU FOR THE ADDITIONAL DOLLARS BECAUSE WE WANT TO DO THE, UM, AWARD, THE DOLLARS FOR THE RECOVERY HOUSE AND DO THAT RIGHT. 
          AND GET THAT GOING BEFORE WE, AS OUR COUNTY EXECUTIVES SAY, LET THE MONEY BURN A HOLE IN OUR POCKET AND SPEND IT RIGHT AWAY. 
          UM, SO WE CONTINUE TO WORK WITH OUR COMMUNITY PARTNERS AND CONTINUE TO LOOK AT THE NEEDS ASSESSMENT, AND WE'LL BE BRINGING FORTH PROPOSALS TO THIS COMMITTEE. 
          UM, BUT RIGHT NOW WE'RE GONNA JUST WAIT, DO OUR FIRST INITIATIVE AND THEN GET A BETTER SENSE OF HOW THE MONEY WILL BE COMING TO OUR COUNTY YEAR OVER YEAR FOR THE NEXT 10 TO 12 YEARS. 
          ANY QUESTIONS? ANY QUESTIONS ON THE AMOUNTS OR HOW THEY'RE GONNA GET READY TO USE THEM AS APPROPRIATE? YES. 
          UM, AND I WOULD JUST SAY, LIKE, I, I DO, I JUST WANNA MAKE SURE THAT THE COMMUNITY DOESN'T, THERE COULD BE A CONCERN FROM THE COMMUNITY, RIGHT? THAT WE'RE SITTING ON THIS MONEY AND NOT DOING ANYTHING WITH IT. 
          UM, BUT ALSO WE HAVE A LOT OF INITIATIVES THAT, THAT WE'VE RECEIVED GRANT FUNDING FOR, UM, THAT WE'VE BEEN IMPLEMENTING OVER THE LAST SEVERAL YEARS THAT I THINK ARE REALLY, UM, MAKING SOME MARK ON THIS, UM, ON THIS CRISIS. 
          UM, SPECIFICALLY OUR DRUG TREATMENT COURT, SPECIFICALLY OUR COS RESPONDER TEAM. 
          AND SO, YOU KNOW, THOSE ARE TWO INITIATIVES THAT ARE SUCCESSFUL AND WE WANT TO CONTINUE. 
          AND SO IT COULD BE THAT THIS MONEY IS USED TO CONTINUE THOSE INITIATIVES, RIGHT? BUT BECAUSE WE HAVE SO MANY THINGS THAT ARE STARTING AND THAT WE'RE, THAT WE'RE WORKING ON, UM, WE WANNA WAIT AND SEE THE OUTCOME OF THOSE SO THAT WE CAN MAKE SURE THAT WE UTILIZE THIS FUNDING, UM, IN THE BEST WAY POSSIBLE FOR OUR COUNTY. 
          UM, BECAUSE EVEN THOUGH WE'RE GONNA GET CONTINUED, YOU KNOW, SORT OF DROPS OF MONEY OVER 12 YEARS, IT'S STILL A FINITE AMOUNT OF MONEY. 
          AND WHEN IT'S DONE, IT'S DONE. 
          THANK YOU. 
          I THINK THAT'S IMPORTANT. 
          AND COULD YOU MAYBE ALSO, JULIE, AT A HIGH LEVEL, UM, EXPLAIN FOR OUR BENEFIT AND THE COMMUNITY'S BENEFIT THAT THERE ARE SPECIFICS VERY MUCH INVOLVED WITH HOW THESE DOLLARS ARE USED, UM, AREN'T THERE OUTLINES AND YOU CAN'T TAKE SOME OF THE MONEY THAT WE AND, AND BUILD A NEW MUNICIPAL SWIMMING POOL, RIGHT, . 
          SO, UM, I JUST THINK FOR THE COMMUNITY AND FOR OUR BENEFIT, IF YOU, I DON'T KNOW IF YOU HAVE SOME OF THE HIGH LEVEL SPECIFICS THAT YOU COULD SHARE OR AT, AT THE TIME THAT IT'S RIGHT. 
          THAT, THAT WE UNDERSTAND THAT WE DON'T HAVE THIS MONEY. 
          YEAH. 
          AND I CERTAINLY CAN BRING BACK A MORE, UM, DETAILED REPORT ON WHAT, WHAT THOSE FUNDS ARE, ESPECIALLY AS, UM, IT'S VERY LIKELY OVER THE NEXT YEAR AND TWO, THIS COMMITTEE WILL HELP US TO, YOU KNOW, DETERMINE WHERE THAT THOSE DOLLARS ARE GONNA BE SPENT. 
          UM, BUT IT'S ESSENTIALLY, UM, EARMARKED OR, OR, OR DESIGNED TO MITIGATE THE EFFECTS OF THE OPIOID CRISIS. 
          AND SO THAT IS A NUMBER OF THINGS RELATED TO RECOVERY, RELATED TO, UM, HOUSING, RELATED TO TREATMENT, UM, YOU KNOW, A NUMBER OF DIFFERENT THINGS, UM, TO KEEP PEOPLE, UM, GETTING PEOPLE SOBER, HELPING PEOPLE STAY ALIVE, UM, MITIGATING, YOU KNOW, JUST ESSENTIALLY THE, THE RISKS AND THE OUTCOME OF, OF THE CRISIS. 
          RIGHT. 
          THAT'S HELPFUL. 
          THANK YOU. 
          SUPERVISOR GALLES. 
          I, SO YES, IT'S, UM, FUNDS THROUGH 2038 AT ROUGHLY WHAT, 250 KA YEAR? SOMETHING, UM, AFTER THE FIRST FEW YEARS. 
          SO TO YOUR POINT, IF WE'RE GONNA BE SPENDING THAT, IT SHOULDN'T BE SOMETHING THAT'S ONGOING PAST 2038, AND I, I KNOW WE HAVE A FURTHER DISCUSSION ITEM AND, YOU KNOW, IF, IF IT, YOU KNOW, GOES TO THE, UM, HOUSING, YOU KNOW, WHAT DOES THAT MEAN? DOES THAT MEAN MAINTENANCE? DOES IT MEAN STAFF? DOES IT MEAN PROPERTY TAX? DOES IT, YOU KNOW, WHAT, WHAT, SO IT WOULD BE INTERESTING, UH, TO SEE HOW, YOU KNOW, WE ALLOCATE THAT 200 SOME ODD THOUSAND DOLLARS, UH, A YEAR OVER THE, THE 2038 TIMEFRAME. 
          YEAH, I MEAN, I ABSOLUTELY AGREE. 
          AND I THINK ON THE NEXT AGENDA ITEM, I'M GONNA TALK A LITTLE BIT MORE ABOUT, UM, WHAT THE NEEDS WILL BE WITH THIS INVESTMENT IN A RECOVERY HOUSE MIGHT BE, AND WHERE WE MIGHT HAVE TO UTILIZE THESE DOLLARS, UM, FOR A PERIOD OF TIME. 
          GREAT. 
          ANY OTHER QUESTIONS? ALL RIGHT. 
          THANK YOU, JULIE. 
          [e. Recovery Housing Needs Assessment]
NEXT ITEM IS THE RECOVERY HOUSE ON THE NEEDS ASSESSMENT. 
          [00:40:01]
UH, OKAY, THAT'S ANOTHER PROVIDER. 
          SO VERY COMPREHENSIVE. 
          AS SUPERVISOR SCH SAID TO ME, UH, COMPREHENSIVE REPORT FOR YOU, UM, THAT I HOPE YOU HAD THE OPPORTUNITY TO READ OR AT LEAST READ THE EXECUTIVE SUMMARY. 
          UM, SO, UM, AS YOU MAY BE AWARE, UM, FOR THOSE WHO'VE BEEN ON THE COUNTY BOARD, UM, THERE WAS APPROVAL GIVEN, UM, AT THE END OF 2022, UM, EAR TO EARMARK A MILLION DOLLARS OF OUR OPIOID SETTLEMENT, UM, FUNDS, UM, TO ISSUE OUT AN RFP FOR SOMEBODY TO OPEN, BUILD AND BUILD OR OPEN, UM, A SOBER LIVING SLASH RECOVERY HOUSE. 
          SO IN 2023, AS WE GRAPPLED WITH HOW TO PUT THIS RFP TOGETHER, UM, AND WHAT THIS SHOULD LOOK LIKE, WE REALLY STRUGGLED BECAUSE WE ARE NOT EXPERTS, UM, IN OUR DEPARTMENT IN RECOVERY HOUSING, UM, SPECIFICALLY. 
          AND, UM, AND I ALSO IN MY ROLE, AM VERY COGNIZANT ABOUT THE FACT THAT THIS IS, I SAID BEFORE FINITE MONEY, AND THIS IS OUR OPPORTUNITY TO PUT A SERVICE AND START A SERVICE IN WASHINGTON COUNTY AND WANTING IT TO BE DONE RIGHT. 
          UM, BUT THEN NOT BEING THE EXPERT, WE STRUGGLED INTERNALLY. 
          SO WE MADE THE DECISION, UM, AT, IN THE MIDDLE OF LAST YEAR TO REACH OUT TO, MADE A HOUSE. 
          UM, IF YOU'RE NOT FAMILIAR THERE, A LONGSTANDING, UM, WOMEN'S RECOVERY, UM, AND HOUSING, UM, PROGRAM OUT OF MILWAUKEE. 
          BUT MANY WOMEN IN THE STATE OF WISCONSIN GO THERE BECAUSE THEY'RE SO LIMITED, UM, NUMBER OF, UM, AVAILABLE SPACES FOR WOMEN TO RECEIVE COV RECOVERY AND HOUSING. 
          UM, THEY ARE CONSIDERED THE EXPERTS IN THE STATE. 
          UM, AND SO WE ENGAGED THEM, UM, TO HELP US IN THIS PROCESS. 
          AND SO WE UTILIZED SOME ARPA FUNDS THAT WE RECEIVED FROM THE STATE TO CONTRACT WITH THEM TO DO THIS NEEDS ASSESSMENT TO HELP US REALLY UNDERSTAND, UM, WHAT IS REALLY THE NEED, WHAT SHOULD WE REALLY BE DOING, HOW DO WE GO ABOUT DOING THIS? AND SO THEY SPENT THE BETTER, UM, PART OF LAST YEAR AND, UM, EARLY THIS YEAR DOING THAT WORK FOR US AND PUTTING THIS, UM, REPORT TOGETHER FOR US. 
          AND SO NOT SURPRISING, UM, YOU KNOW, THE, THE OUTCOME OF THE REPORT IS THAT WASHINGTON COUNTY REALLY COULD BENEFIT FROM, UM, A SOBER LIVING RECOVERY HOUSE AROUND THE RANGE OF SIX TO EIGHT BEDS. 
          UM, BUT WHAT THEY DID FIND IN THEIR, UM, ANALYSIS AND THE FEEDBACK THAT THEY GAVE TO US IS THAT IT'S VERY UNLIKELY THAT THERE'S GOING TO BE AN ENTITY WHO CAN GET INTO THIS GAME AND OPEN UP THIS FACILITY THAT WON'T NEED ONGOING SUPPORT FROM THE COUNTY. 
          AND SO THAT OBVIOUSLY IS SORT OF THE QUOTE UNQUOTE SMOKING GUN FOR US, RIGHT. 
          OF, OF MAKING THAT DECISION. 
          UM, AND SO, UM, THAT IS WHERE I THINK, UM, YOU KNOW, WE'RE LOOKING AT SOME OPPORTUNITIES WITHIN OUR BUDGET AND THEN ALSO LOOKING AT THE, THE OPIOID SETTLEMENT DOLLARS AND HOW CAN WE CONTINUE TO SUPPORT, UM, OPERATIONALLY A FACILITY LIKE THIS SO THAT IT IS SUCCESSFUL AND WHAT OPERATION SUPPORT MEANS TYPICALLY. 
          AND WHAT, WHAT WE'LL PUT IN THE RFP IS NOT THAT WE'RE JUST GONNA FUND THEM, YOU KNOW, FOR THEIR FULL OPERATIONAL DOLLARS ONGOINGLY AND FOR ETERNITY, IT'S REALLY ABOUT SUPPORTING INDIVIDUALS FOR A PERIOD OF TIME. 
          SO AN INDIVIDUAL WHO, UM, GOES INTO SOBER LIVING, UM, TYPICALLY IS COMING OUT OF, UH, RECOVERY OR TREATMENT AND IS WORKING ON THAT STABILITY. 
          SO THEY'RE WORKING ON EMPLOYMENT AND THEY'RE WORKING ON, UM, YOU KNOW, REPAIRING SOME OF THEIR RELATIONSHIPS AND THINGS LIKE THAT. 
          UM, AND SO THEY NEED SUPPORT FOR THE COST OF THEIR STAY UNTIL THEY'RE ABLE TO SUP PROVIDE THEIR OWN, UM, PAYMENT. 
          SO ESSENTIALLY THEIR OWN RENT THERE. 
          SO MAITA HOUSE SHARED WITH US THAT IN THEIR, UM, THAT THEY TYPICALLY CONTRACT WITH COUNTIES FOR, UM, THE FIRST THREE TO FOUR MONTHS AT A SET RATE. 
          AND SO AS WE, UM, GO DOWN THE ROAD OF, UM, FINALIZING THIS RFP AND SEEING THE PROVIDERS WHO ARE INTERESTED IN RESPONDING TO IT, WE'LL HAVE A BETTER SENSE OF WHAT THAT YEARLY AMOUNT MAY BE, UM, IN OPERATIONAL SUPPORT, UM, AND THEN LOOKING, UM, TO THIS COMMITTEE TO, UM, EITHER FIGURE OUT SOMETHING CURRENTLY IN THE HUMAN SERVICES BUDGET OR LOOKING AT THE OPIOID SETTLEMENT DOLLARS, UM, IN THE FUTURE. 
          UM, SO I'M GONNA STOP THERE AND SEE IF THERE'S ANY QUESTIONS. 
          YES. 
          PROFESSOR BA UH, WHAT'S THE AVERAGE STAY? UM, YOU KNOW, YOU MENTIONED THAT AFTER THREE TO FOUR MONTHS THEY TEND TO HAVE GOTTEN TO A POINT WHERE THEY HAVE EMPLOYMENT AND THEY CAN PAY THEIR OWN RENT. 
          WHAT'S THE OVERALL AVERAGE DAY FOR SOMEBODY IN ONE OF THESE FACILITIES? FROM WHAT I UNDERSTAND, IT'S ABOUT 12 TO 18 MONTHS. 
          OKAY. 
          [00:45:01]
SO WE'RE LOOKING, AND THIS IS A SEVEN BED FACILITY WE'RE LOOKING AT, RIGHT? OR YEP. 
          SO THE, UM, THE RFP THAT WE'LL ISSUE, WE'LL, WE'LL TALK ABOUT THAT. 
          WE'RE LOOKING FOR SOMEBODY WHO CAN OPEN UP A SIX TO EIGHT BED. 
          OKAY. 
          SO REALLY MATHEMATICALLY IT'S THE EQUIVALENT OF FUNDING TWO BEDS AT ANY GIVEN TIME. 
          UM, SO IF I'M KIND OF, AND THAT'S ROUGH MATH, THAT'S NOT EXACT BY ANY MEANS. 
          SO IT'S REALLY A FOURTH OF THE OPERATIONAL COST OF THIS FACILITY. 
          DOES THAT SOUND KINDA RIGHT BY YOUR THOUGHT AS TO WHAT, YOU KNOW, ROUGH MATH, WHAT IT LOOKS LIKE? YEAH, WELL, I'M A SOCIAL WORKER, SO THIS IS MY KIND OF MATH . 
          AND SO, UM, SO I WOULD SAY, UM, PROBABLY UPFRONT, UM, THERE WOULD BE MORE COSTS, RIGHT? BECAUSE AS THEY OPEN AND, AND WHEN, WHAT WE'RE UNSURE ABOUT IS IF THAT WILL ENCOMPASS THE MILLION DOLLARS OR IF THEY'LL NEED SOME UPFRONT OPERATIONAL DOLLARS TO START. 
          UM, BUT THAT SOUNDS ABOUT RIGHT. 
          MY OWN MATH HAS KIND OF PUT THIS, THAT I AM GUESSING THIS TO BE A HUNDRED THOUSAND DOLLARS OR LESS A YEAR INVESTMENT OPERATIONALLY, BUT IT WOULD BE, UM, IT WOULD NOT BE ON A AUTOMATIC, IT WOULD BE ON A PAY PER INDIVIDUAL BASIS. 
          YEAH. 
          AND I GUESS KIND OF THINKING IT THROUGH THE O OPIOID SETTLEMENT MONEY HAS TO BE USED FOR OPIOID ABATEMENT, AND THIS IS FOR SURE OPIOID ABATEMENT, SO IT MAKES LOGICAL SENSE TO FUND THIS OUT OF THE OPIOID SETTLEMENT AND OTHER THINGS WE MIGHT WANNA FUND THAT MIGHT OR MIGHT NOT QUALIFY, WE THEN HAVE THE OPTION TO DO HUMAN SERVICES FUNDING INSTEAD. 
          MM-HMM. 
          , DOES THAT KIND OF MAKE SENSE TO YOU AS WELL? YES. 
          YEAH. 
          OKAY. 
          AND SO THEN I JUST REMEMBER I HAD LOST MY TRAIN OF THOUGHT FOR A SECOND. 
          SO, UM, I WANNA JUST SHARE WITH YOU AS WELL THAT THE NEXT STEP IN THIS IS MADE A HOUSE IS CURRENTLY, UM, HAS COMPLETED A CHARTER WITH US ON THE RFP OF ALL THE ITEMS THAT WE WOULD WANT. 
          AND THEY ARE WRITING THE RFP FOR US. 
          UM, OUR PLAN IS TO, UM, HAVE THAT COMPLETED AND ISSUED BY QUARTER THREE AND QUARTER FOUR OF THIS YEAR, AND WITH A, A GOAL OF AWARD MAKING AN AWARD IN QUARTER ONE OF 25. 
          OKAY. 
          AND ONCE WE'VE MADE THAT AWARD, WHAT IS A LIKELY TIMEFRAME FOR BUILDING THIS FACILITY AND GETTING IT STARTED? ARE WE LOOKING AT ABOUT 18 MONTHS OR LONGER THAN THAT? I, I WOULD BELIEVE THAT IT COULD BE DONE IN 18 MONTHS. 
          MY, MY GUESS IS SOMEBODY'S NOT GONNA REALLY BE ABLE TO BUILD SOMETHING, UM, JUST GIVEN THE COST OF, YOU KNOW, THEY'RE LIKELY GOING TO BE PURCHASING OR RENTING THE COST MOST LIKELY WILL BE IN LIKE RENOVATION YEAH. 
          AND PURCHASING. 
          AND THERE'S A LOT OF STUFF THAT I HAVE TO WORK OUT WITH A COUNTY ATTORNEY ON WHAT THAT MEANS WHEN WE GIVE MONEY FOR SOMEBODY TO MAKE A PURCHASE. 
          . 
          MM-HMM. 
          , YES. 
          NER WHEN PEOPLE, WHEN PEOPLE LEAVE THE, UM, FACILITY, IS THERE CARE FOR THEM AFTER THEY LEAVE? UM, IS THAT PART OF ANY PLAN? YEP. 
          SO THERE, UM, THERE ARE STANDARDS IN, UH, SOBER LIVING CALLED NAR STANDARDS AND SOMEBODY CAN, UM, BUILD A LEVEL ONE THROUGH A LEVEL FOUR FACILITY. 
          AND BASED ON THE LEVEL THAT THEY CHOOSE AND THE STANDARDS THAT THEY ADHERE TO, IT DEPENDS ON THE ENCOMPASSMENT OF ALL THE SERVICES THAT ARE PROVIDED, INCLUDING, UM, AFTERCARE, UM, IF SOMEBODY LEAVES. 
          TYPICALLY, HOWEVER, UM, OUR EXPERIENCE HAS BEEN MOST OF THE FOLKS WHO ARE, UM, RECEIVING SERVICES IN THIS SPACE, UM, ARE CONNECTED IN SOME WAY OR THE OTHER, EITHER WITH OUR DIVERSION PROGRAMS THROUGH DRUG COURT OR OUR TAD PROGRAM THROUGH OUR CLINIC, UM, RECEIVING SERVICES OR THROUGH SOME OF OUR COMMUNITY PARTNERS THAT WE FUND FOR TREATMENT. 
          AND SO THERE, THERE IS A SORT OF COMPREHENSIVE, UM, SERVICES AVAILABLE IN THE COMMUNITY. 
          AND ESPECIALLY WHEN SOMEBODY GETS, UM, FURTHER ALONG IN THEIR SOBRIETY, THERE REALLY IS, UH, SERVICES AND CONNECTION TO SOME OF THOSE AFTERCARE SUPPORT SYSTEMS. BUT WHAT RECOVERY HOUSE REALLY OFFERS IS THAT THAT INTERMEDIARY SUPPORT FOR PEOPLE IN A TIME THAT THEY'RE VERY VULNERABLE AND OFTEN DON'T HAVE ANOTHER, UM, RESIDENCE TO GO TO BECAUSE EITHER THEY'VE BURNED SOME BRIDGES WITH THEIR CURRENT FAMILY OR FRIENDS, OR THE ONLY OTHER OPTION IS FOR THEM TO GO BACK TO A SITUATION WHERE PEOPLE ARE STILL USING AND THAT, THAT MAKES THEM VERY VULNERABLE THEN FOR RELAPSE. 
          [00:50:03]
ANY OTHER QUESTIONS? COMMENTS? OKAY. 
          YEAH. 
          SUPERVISOR GALLS. 
          YEAH, I'M SURE WE'RE GONNA SPEND SOME MORE TIME. 
          AND SO I, AND IT, THE, THE 122 PAGES IS  COMPREHENSIVE, BUT IF I GO TO WHATEVER CONCLUSION PAGE, IT IS RECOMMENDED THAT WASHINGTON COUNTY ESTABLISH A RECOVERY RESIDENCE SUPPORT ITS RESIDENTS. 
          UM, THAT MAY, IF I'M NOT MISTAKEN, THAT WOULD, IS THAT ALSO IMPLYING THAT WASHINGTON COUNTY PAY FOR THAT ONGOING MAINTENANCE AND STAFFING OF THAT FACILITY? SO IN THEIR RECOMMENDATION AND WHAT THEY FOUND IN THEIR ASSESSMENT AND THEN ALSO BASED ON THEIR OWN EXPERIENCE, IS THAT THERE IS A RECOMMENDATION THAT THERE'S SOME SUPPORT, NOT THAT WASHINGTON COUNTY CAN SUPPORT THE OPERATIONS AT A HUNDRED PERCENT, UM, BUT THAT THERE IS SOME SUPPORT AND SPECIFICALLY WHEN PEOPLE ARE COMING IN WITH NO RESOURCES. 
          UM, AND SO, YOU KNOW, WE WOULD OFFER THAT PAYMENT IN THE FIR FOR THE FIRST THREE OR FOUR MONTHS. 
          UM, BUT THAT IS PART OF WHAT THE RFP IS REALLY TRYING TO ELICIT IS WHAT IS THIS ORGANIZATION WHO WANTS TO RUN THIS PLAN FOR SUSTAINABILITY, KNOWING THAT, YOU KNOW, WE'RE, WE'RE WILLING TO HAVE THAT CONVERSATION ABOUT CON CONTRACTING FOR INDIVIDUALS FOR A PERIOD OF TIME, BUT THERE IS NO INTENT FOR THE COUNTY TO PROVIDE A HUNDRED PERCENT ONGOING OPERATIONAL DOLLARS. 
          SPEAKING TO THAT, UM, ON, ON COVERAGE, IS THERE, UM, MEDICAID COVERAGE FOR ANY OF THE POST, WHATEVER THEIR TREATMENT WAS AND, AND THEN THE, UM, SOBER LIVING, UH, OR OTHER INSURANCES FOR EXAMPLE? IS THAT COVERED? NOT FOR HOUSING. 
          NOT FOR HOUSING, FOR TREATMENT AND SERVICES LIKE THAT. 
          BUT NOT FOR HOUSING. 
          OKAY. 
          THANK YOU. 
          ANYTHING ELSE? SUPERVISOR BOSER? UM, ARE THERE OTHER POTENTIAL GRANTS AVAILABLE THAT THIS FACILITY COULD WRITE FOR? AND IF SO, WOULD WE BE REQUIRING THAT THEY ALSO PURSUE THOSE? YES. 
          AND UM, THERE'S BEEN SOME RECENT INDICATION THAT THE STATE MIGHT BE ISSUING, UM, SOME FUNDING OUT OF THEIR SETTLEMENT DOLLARS. 
          AND SO IT IS ON OUR RADAR AND IF, IF WE'RE ELIGIBLE, WE WILL APPLY FOR IT TO SUPPORT THIS. 
          OKAY, THANK YOU. 
          IS THERE ANY SUPPORT FROM FAITH-BASED ORGANIZATIONS FOR HOUSING? UM, NOT FOR HOUSING SPECIFICALLY. 
          OKAY. 
          ALRIGHT. 
          THANK YOU. 
          ANY OTHER QUESTIONS? ALL RIGHT, THANK YOU JULIE. 
          THANK YOU. 
          SO THE NEXT ITEM 
          [f. 2024 Resolution: Children’s Long Term Support Case Manager Position]
ON OUR AGENDA IS THE 2024 RESOLUTION OF CHILDREN'S LONG-TERM SUPPORT CASE MANAGEMENT POSITION. 
          I WOULD ENTERTAIN A MOTION AND A SECOND TO OPEN DISCUSSION MOTION BY SUPERVISOR BOSER, SECOND BY SUPERVISOR BAILEY. 
          ALL RIGHT. 
          AND WE'RE GONNA HEAR FROM KELLY AND OR SARAH, IS THAT RIGHT? YES. 
          UM, YES, WE ARE GOING TO TALK ABOUT THE YOUTH TREATMENT TEAM AS YOU HEAR ME. 
          YEAH, JUST STEP FORWARD A LITTLE BIT. 
          THANK YOU. 
          STAND IN FRONT OF YOU. 
          UM, WE'RE GONNA TALK ABOUT THE YOUTH TREATMENT TEAM, UH, AS A WHOLE AND THEN FOCUS REALLY ON CHILDREN'S LONG-TERM SUPPORT OR CLTS. 
          UM, DO A LITTLE DEEP DIVE ON THAT FOR YOU. 
          SO, UM, WE WILL START OFF WITH, UH, INTRODUCTIONS. 
          UM, I'M SARAH WITTY, I'M THE YOUTH TREATMENT TEAM SUPERVISOR. 
          UM, SO THIS IS JUST A GENERAL OVERVIEW OF SOME OF THE THINGS THAT I'M RESPONSIBLE FOR, FOR IN OUR YOUTH TREATMENT TEAM. 
          UM, THAT INCLUDES OVERSIGHT OF ALL OF OUR YOUTH TREATMENT PROGRAMS, WHICH WE'LL TALK MORE ABOUT, UM, DIRECT SUPERVISION OF STAFF, CONTRACT MANAGEMENT, UM, SOME INVOICE APPROVAL, AND, YOU KNOW, MONITORING OUR SPENDING OF OUR PROGRAMMING. 
          UM, AND THEN JUST, YOU KNOW, MAKING SURE THAT OUR PROGRAMS ARE BEING RUN TO FIDELITY AND WE'RE DOING THINGS THE WAY THAT WE'RE SUPPOSED TO BE DOING THEM. 
          AND I'LL LET YOU, HI THERE. 
          I AM KELLY BELL. 
          SO I AM THE ASSISTANT SUPERVISOR OF YOUTH TREATMENT. 
          UM, SO I PRIMARILY HANDLE ALL OF THE INITIAL REFERRALS FOR, UM, THE CCS PROGRAM AND THE C-C-L-T-S PROGRAM, DOING THE FUNCTIONAL SCREENS, DETERMINING ELIGIBILITY, AND THEN GETTING THEM CONNECTED OR ON THE WAIT LIST DEPENDING ON WHERE WE'RE AT THERE. 
          UM, I ALSO SUPERVISE AND MANAGE THE FCT, UH, PROGRAM FAMILY-CENTERED TREATMENT, UH, THAT HAS THREE THERAPISTS CURRENTLY. 
          UM, AND THEY PROVIDE INTENSIVE IN-HOME THERAPY TO FAMILIES IN THE COMMUNITY. 
          UM, I ALSO, ALONG WITH SARAH, MANAGE KIND OF THE, THE DAY TO DAY THE FIDELITY, 
          [00:55:01]
UM, INVOICES AND SUPPORTING OUR CONTRACTED AGENCIES. 
          AND THANK YOU FOR USING OR SPELLING OUT THE ACRONYMS BECAUSE I KNOW SOCIAL WORK IS FILLED WITH THEM. 
          SO THANK YOU FOR SAYING WHAT THEY ARE. 
          I'M PRETTY SURE THAT WAS ALL. 
          JULIA FILLED THAT IN NOW WHEN WE WERE, UH, GOING THROUGH THIS. 
          SO, UM, IT'S A LOT OF ACRONYMS. IT'S A LOT OF C ACRONYMS TOO, SO THAT MAKES IT EVEN MORE COMPLICATED. 
          YEAH. 
          UM, SO THIS IS JUST A REAL BRIEF OVERVIEW OF WHAT THE YOUTH TREATMENT TEAM ALL ENCOMPASSES. 
          UM, IT INCLUDES OUR BIR TO THREE PROGRAM, WHICH IS EARLY INTERVENTION SERVICES FOR CHILDREN, UM, WHO HAVE, UH, IDENTIFIED DELAYS OR DISABILITIES, UH, FROM AGE ZERO TO THREE. 
          WE CONTRACT THAT PROGRAM OUT WITH THRESHOLD HERE IN WEST BEND. 
          UM, AND THEN OUR CHILDREN'S LONG TERM SUPPORT, CLTS, YOU MIGHT HEAR WAIVER SERVICES. 
          THAT'S ALL THE SAME PROGRAM, UM, THAT IS SERVICES FOR CHILDREN WITH DISABILITIES. 
          UM, AND THEN YOU CAN SEE WE'VE GOT SOME NUMBERS HERE FOR HOW MANY CHILDREN, BIRTH TO THREE SERVED IN 2023, AND THEN HOW MANY CHILDREN WE CURRENTLY HAVE IN CLTS, UM, AS WELL AS HOW MANY CHILDREN WE HAVE ON THE WAIT LIST. 
          UM, AND THEN WE HAVE EIGHT CHILDREN THAT ARE IN WHAT THEY CALL DEFERRED STATUS. 
          AND BASICALLY WHAT THAT MEANS IS IF A, WHEN A FAMILY COMES UP ON THE WAIT LIST AND WE CALL THEM AND SAY, HEY, WE'RE READY TO ENROLL YOU, SOMETIMES FAMILIES WILL SAY, OH, I'M NOT SURE. 
          LIKE, WE'VE GOT A LOT GOING ON, WE'VE GOT A LOT OF OTHER SERVICES, IT'S MAYBE NOT A GOOD TIME. 
          SO THEY CAN CHOOSE TO DEFER SERVICES AND IT HOLDS THEIR PLACE ESSENTIALLY SO THEY DON'T HAVE TO GO BACK THROUGH THE WHOLE PROCESS AGAIN. 
          UM, BUT THEY CAN CHOOSE TO WAIT AND PAUSE UNTIL THEY'RE READY TO COME IN. 
          UH, WE HAVE SOME ADDITIONAL NUMBERS HERE FOR COMPREHENSIVE COMMUNITY SERVICES CCS. 
          SO WE HAVE 112 CHILDREN CURRENTLY ENROLLED BETWEEN THE TWO AGENCIES WE CONTRACT WITH. 
          AND WE CURRENTLY HAVE 23 REFERRALS, UM, AND OUR CONTRACTED STAFF ARE PRETTY FULL. 
          SO WE'RE EXPANDING THAT PROGRAM WITH THE CONTRACTED PROVIDERS. 
          UM, FOR FAMILY-CENTERED TREATMENT, WE HAVE 12 CURRENTLY ENROLLED, A FULL CASELOAD IS FIVE TO SIX, UM, BECAUSE IT IS, UH, FOUR TO SIX HOURS OF IN-HOME THERAPY. 
          AND WE CURRENTLY HAVE SIX REFERRALS ON THE WAIT LIST. 
          ALRIGHT. 
          AND THEN THIS IS JUST A GENERAL STAFF OVERVIEW OF WHAT EACH OF THOSE PROGRAMS CONTAINS. 
          UM, SO YOU CAN SEE OUR CLTS PROGRAM RIGHT NOW HAS EIGHT CASE MANAGERS AND A LEAD CASE MANAGER. 
          AND KELLY, MYSELF AND I BOTH PROVIDE SUPPORT TO THAT PROGRAM. 
          UM, BURST OF THREE HAS FOUR CHILD DEVELOPMENT SPECIALISTS AND ONE SUPERVISOR CURRENTLY, AND THEN FOUR CCS. 
          UM, WITH SERONA, WE HAVE FIVE FULL-TIME STAFF AND ONE PART-TIME STAFF DOING CASE MANAGEMENT. 
          UM, AND THE PART-TIME STAFF IS A FAMILY SUPPORT SPECIALIST AND WELLPOINT HAS SIX FULL-TIME STAFF DOING, UM, CASE MANAGEMENT. 
          AND THEN WE HAVE EIGHT ANCILLARY PROVIDERS. 
          SO THESE ARE THE FOLKS THAT DO THE ACTUAL WORK FOR THESE CLIENTS. 
          UM, AND SARAH AND I APPROVE ALL OF THOSE INVOICES. 
          UM, FOR FCT, WE HAVE ONE INTERNAL THERAPIST AND TWO CONTRACTED PROVIDERS THROUGH PSG. 
          UM, AND WE WORK AS A TEAM. 
          ALL RIGHT. 
          SO, UM, WE'RE GONNA TALK MORE SPECIFICALLY ABOUT CHILDREN'S LONG-TERM, LONG-TERM SUPPORT AND THAT PROGRAM AND, UM, WHAT THAT ALL ENTAILS. 
          UM, AT ITS CORE, CLTS IS A PROGRAM THAT PROVIDES SUPPORT, UM, FOR FUNDING AND SERVICES FOR CHILDREN WITH DISABILITIES. 
          WE CAN SERVE AGES ZERO TO 22. 
          TYPICALLY, WHEN KIDS GET AROUND THAT 17, 18 RANGE, WE ARE HELPING THEM TRANSITION TO ADULT PROGRAMMING. 
          SO IT'S RARE THAT WE KEEP KIDS TO 22, UM, BUT WE DO HAVE THAT ABILITY. 
          UM, SO IF THERE IS A PROBLEM WITH TRANSITION OR THINGS DON'T GO AS TIMELY AS WE HOPE THEY WILL, WE HAVE THAT LITTLE BIT OF A BUFFER TO BE ABLE TO KEEP KIDS IN PROGRAMMING SO THEY DON'T JUST LOSE SERVICES ABRUPTLY. 
          UM, THERE CAN BE A PARENTAL FEE INVOLVED WITH CLTS THAT IS BASED ON A FORMULA THAT THE STATE, UH, HAS COME UP WITH. 
          UM, AND IT LOOKS AT, UH, FAMILY SIZE AND INCOME. 
          AND THEN THERE COULD BE A PERCENTAGE THAT FAMILIES ARE RESPONSIBLE FOR, THEY'RE NEVER CHARGED FOR THE FULL COST OF THEIR SERVICES, BUT THERE IS SOMETIMES A PARENTAL, UH, PERCENTAGE, UM, INVOLVED. 
          UM, IT IS A NEEDS-BASED PROGRAM. 
          SO WE ARE ALWAYS LOOKING AT CONNECTING A SERVICE TO A NEED. 
          SO LOOKING AT THAT CHILD AND WHAT DO, WHAT DO THEY HOPE TO GET OUT OF PROGRAMMING OR SERVICES? WHAT DO THEY HOPE TO SEE CHANGE OR GET BETTER OR, UM, IMPROVE FOR THEIR FAMILY? AND THEN CONNECTING THAT BACK TO THE SERVICE. 
          UM, AND THEN WE ARE A FUNDING OF LAST RESORT. 
          SO THAT MEANS IF THERE'S ANY OTHER WAY TO FUND A SERVICE, IT HAS TO GO THAT WAY BEFORE IT WOULD COME TO US. 
          SO A LOT OF TIMES WE SEE THIS WITH INSURANCE, RIGHT? WE MIGHT ASK SOMEBODY, CAN YOU TRY TO GET IT COVERED UNDER INSURANCE? LET US SEE A DENIAL BEFORE WE WOULD STEP IN. 
          UM, THESE ARE SOME EXAMPLES OF SERVICES THAT WE WOULD COVER. 
          UM, IT'S JUST A REAL BRIEF LIST AND I WILL HOPEFULLY BRING UP MY LINK HERE MAYBE. 
          ALL RIGHT, SUCCESS. 
          UM, SO THIS IS WHAT IS THE SERVICES AT A GLANCE? THIS IS SOMETHING THAT THE STATE HAS, UH, PUT TOGETHER THAT KIND OF GIVES A BRIEF OVERVIEW OF WHAT COULD BE OFFERED THROUGH CLTS. 
          SO WE GIVE THIS TO FAMILIES WHEN THEY'RE APPLYING, AND 
          [01:00:01]
THEN EVERY YEAR THEY GET A NEW COPY OF THIS. 
          UM, AND IT GIVES YOU AN IDEA OF, I CAN SCROLL THROUGH IT MAYBE, MAYBE THERE WE GO. 
          UM, THE DIFFERENT CATEGORIES OF SERVICES AND THEN THE PARTICULAR SERVICES IN THAT CATEGORY, AS WELL AS SOME EXAMPLES. 
          UM, A RESPITE IS PROBABLY THE BIGGEST SERVICE THAT WE SEE, SO THAT IS A BREAK FOR PARENTS. 
          YOU KNOW, WE CAN PAY FOR A CAREGIVER TO COME IN, TAKE CARE OF A CHILD SO THAT PARENTS CAN RUN SOME ERRANDS, SPEND SOME TIME TOGETHER, WHATEVER THEY MIGHT NEED TO DO. 
          UM, IF I SCROLL THROUGH THIS A LITTLE BIT FURTHER, YOU CAN SEE WE CAN DO SOME ALTERNATIVE THERAPIES, THINGS LIKE MUSIC THERAPY, ART THERAPY, EQUINE THERAPY THAT AREN'T USUALLY COVERED BY TRADITIONAL INSURANCE, BUT CAN BE REALLY HELPFUL, ESPECIALLY FOR KIDS WITH DISABILITIES WHO ARE MAYBE NONVERBAL AND CAN'T PARTICIPATE IN TRADITIONAL TALK THERAPY. 
          UM, WE CAN DO A LOT OF DIFFERENT, UH, ADAPTATIONS. 
          SO COMMUNICATION DEVICES, ANYTHING THAT'S GONNA HELP A KID BE ABLE TO ACCESS THEIR COMMUNITY OR BE A PART OF SCHOOL, FAMILY, WHATEVER THAT MIGHT BE. 
          UM, AND THEN WE CAN DO LIKE THINGS LIKE HOME MODIFICATIONS AND VEHICLE MODIFICATIONS. 
          SO IF A KID NEEDS, UM, A RAMP OR A LIFT OF SOME KIND, WE CAN HELP OUT WITH THOSE THINGS. 
          SO THAT GIVES YOU, AGAIN, JUST A REAL BRIEF UH, OVERVIEW OF SOME OF THE THINGS THAT CLTS CAN OFFER. 
          AND THEN LET'S SEE IF I CAN GET BACK TO, OOPS, I LOST OUR SPOT. 
          OKAY. 
          ALL RIGHT. 
          SO, UM, AS I MENTIONED EARLIER, I DO THE FUNCTIONAL SCREENS TO START THE PROCESS FOR CLTS. 
          UM, SO THAT IS, UM, CREATED AND RUN BY DHS BY THE STATE. 
          THEY HAVE SPECIFIC TOOLS, UM, TO COMPLETE THE SCREEN, AND THERE IS A TRAINING PROCESS TO DO THAT. 
          UM, THE IDEA IS WE GET A SNAPSHOT OF THE CHILD'S FUNCTIONING OVER THE PAST SIX MONTHS IN RELATION TO THEIR DIAGNOSIS OR DISABILITY. 
          UM, SO THEY COMPARE WHAT A TYPICAL DEVELOPING CHILD, UM, LOOKS LIKE VERSUS THAT CHILD. 
          AND IF THERE IS A, A, A LARGE GAP THERE AND, AND SOME DEFICITS, THEN THAT'S WHEN THEY WOULD BE ELIGIBLE AND FUNDING COULD COME INTO PLACE. 
          UM, CLTS IS A MEDICAID FUNDED PROGRAM, SO THERE HAS TO BE A SOURCE OF MEDICAID FOR THIS CHILD TO BE ABLE TO BE IN THAT PROGRAM. 
          UM, WE DO HAVE SEVERAL FAMILIES THAT DON'T QUALIFY FOR MEDICAID BASED ON THEIR FAMILY INCOME, AND THAT IS WHEN I WOULD WORK WITH, UH, KATIE BECKETT, UM, WHICH IS A STATE FUNDED PROGRAM. 
          IT'S AN ALTERNATIVE FORM OF MEDICAID FOR KIDS WHO ARE FUNCTIONALLY ELIGIBLE ON THE SAME SCREEN BASED ON THEIR FUNCTIONING VERSUS THE FAMILY INCOME. 
          UM, WAIVER MEDICAID IS ALSO AN OPTION. 
          UM, KATIE BECKETT USUALLY TAKES A FEW MONTHS TO GET INTO PLACE WAIVER MEDICAID. 
          I CAN HELP FAMILIES GET WITHIN A MONTH OF ELIGIBILITY. 
          UM, AND THAT'S USUALLY A PLACEHOLDER UNTIL THAT KATIE BECKETT FUNDING KICKS IN. 
          ALL RIGHT, SO THIS GIVES YOU JUST AN IDEA OF, UH, CLTS AS A WHOLE. 
          IT IS A COUNTY RIGHT? WIDE PROGRAM SHOWS YOU KIND OF WHERE WE'VE GOT CASES ACROSS THE COUNTY. 
          UM, WE DO HAVE TWO OUT OF COUNTY PLACEMENTS RIGHT NOW, UM, WHICH THOSE ARE FOSTER CHILDREN. 
          SO IF A FOSTER KID IS A WASHINGTON COUNTY KID, WE'RE STILL RESPONSIBLE FOR THEM, EVEN IF THEY'RE PLACED OUT OF COUNTY. 
          SO WE CONTINUE TO SERVE THOSE, UM, THOSE KIDS, EVEN IF THEY AREN'T LOCATED IN OUR COUNTY CURRENTLY. 
          UM, WHEN SOMEONE IS ELIGIBLE FOR CLTS, THEY COME UP WITH ELIGIBILITY ACROSS WHAT THEY CALL A TARGET GROUP. 
          SO THERE'S THREE TARGET GROUPS, DEVELOPMENTAL DISABILITY INTO PHYSICAL DISABILITY OR A MENTAL HEALTH DISABILITY. 
          SO YOU CAN SEE THE BREAKDOWN THERE OF WHERE OUR KIDS FALL. 
          DEVELOPMENTAL DISABILITY IS BY FAR THE LARGEST GROUP THAT WE HAVE. 
          UM, AND THEN THERE'S SOME EXAMPLES OF DIAGNOSES WITHIN THOSE CATEGORIES. 
          THIS IS NOT AN EXHAUSTIVE LIST. 
          THERE'S A LOT OF DIAGNOSES OUT THERE THAT FIT IN HERE, BUT THIS IS SOME OF THE COMMON ONES THAT WE SEE. 
          UM, AND YOU'LL NOTICE AUTISM CAN FALL IN A DEVELOPMENTAL DISABILITY OR A MENTAL HEALTH GROUP DEPENDING ON HOW THAT PRESENTS FOR THAT PARTICULAR CHILD. 
          UM, HOW DO PEOPLE LEARN ABOUT CLTS? SO, UH, WE HAVE SEEN A REAL INCREASE IN REFERRALS OVER THE PAST FEW YEARS, AND THAT IS REALLY DUE TO DHS DOING A TON OF OUTREACH AROUND CLTS. 
          UM, THEY'VE DONE A LOT OF WORK WITH MEDICAL PROVIDERS, DOCTORS, UM, DIFFERENT FOLKS IN THAT FIELD TO MAKE SURE THAT THEY ARE AWARE OF THE PROGRAM AND KNOW WHEN THEY ARE DO MAKING THESE KINDS OF DIAGNOSES OR SEEING THESE SORTS OF DISABILITIES OR DELAYS. 
          THEY'RE REFERRING FAMILIES TO OUR PROGRAM. 
          UM, THEY'VE DONE A TON OF LIKE PROMOTIONAL MATERIALS, SO THAT SERVICES AT A GLANCE THAT WE LOOKED AT THAT IS PART OF THAT PROCESS OF, UM, CREATING MORE ACCESSIBLE MATERIALS FOR FAMILIES THAT ARE THAN UNIVERSAL TOO, CAN BE USED ACROSS THE STATE RATHER THAN BEING COUNTY TO COUNTY. 
          AND THEY DIFFER A LITTLE BIT. 
          UM, THEY UPDATE THEIR WEBSITE. 
          THEY HAVE A REALLY NICE WEBSITE NOW THAT FAMILIES CAN ACCESS. 
          UM, THEY'VE DONE A LOT OF LOCAL OUTREACH AROUND PROGRAMMING, AGAIN, WITH SCHOOLS, OTHER PROVIDERS WHO MIGHT BE INTERACTING WITH KIDS. 
          UM, AND THEN WORD OF MOUTH AND SOCIAL MEDIA HAS REALLY MADE A HUGE DIFFERENCE AS WE'VE HAD SO MANY MORE KIDS ENROLL IN PROGRAMMING. 
          WORD GETS OUT AND 
          [01:05:01]
PEOPLE SHARE AND THEY GET CONNECTED TO OTHER FAMILIES, UM, AND THEN COME TO US . 
          UM, SO THIS IS A LITTLE BIT OLD. 
          UM, OBVIOUSLY YOU CAN SEE IT'S FROM 2016, BUT THIS IS THE LAST TIME THAT DHS GAVE US SOME OF THIS INFORMATION. 
          AND WHAT THEY DID WAS LOOKED AT DISABILITY RATES AROUND THE STATE AND COUNTY TO COUNTY TO GIVE PEOPLE AN IDEA OF LIKE, WHAT COULD WE POTENTIALLY HAVE AS FAR AS ELIGIBLE CHILDREN. 
          UM, SO YOU'LL SEE OUR DISABILITY RATE FOR WASHINGTON COUNTY IS ABOUT 3%. 
          UM, AND THEN THE NUMBER OF CHILDREN THAT WOULD POTENTIALLY BE ELIGIBLE BASED ON THAT IS 930, WHICH IS A LOT OF KIDS. 
          UM, SO WE HAVE 305 RIGHT NOW. 
          POTENTIALLY ELIGIBLE KIDS WOULD BE A LOT MORE THAN THAT. 
          UM, THIS IS NOT, THAT DOES NOT MEAN THAT EVERY SINGLE ONE OF THOSE KIDS WOULD BE ELIGIBLE OR COME INTO PROGRAMMING, BUT IT GIVES US A SENSE OF WHAT COULD BE OUT THERE AND WHAT WE COULD REACH, UM, IF WE CONTINUE TO SEE THE REFERRALS AT THE RATE THAT WE ARE, UM, OUR PROGRAM GROWTH OVER TIME. 
          SO AGAIN, I HAVE SORT OF MENTIONED THAT, UH, OUR REFERRALS HAVE GONE UP A LOT, ESPECIALLY OVER THE PAST FIVE YEARS. 
          UM, SO YOU CAN KIND OF SEE HOW THAT HAS LOOKED FOR US BOTH FROM A STAFF PERSPECTIVE AND A, UH, ENROLLMENT PERSPECTIVE. 
          UM, WE HAVE ADDED A LOT OF STAFF OVER THE PAST, YEAH, FIVE YEARS, UM, AND ADDED A LOT OF CHILDREN. 
          AND NOW AT OUR POINT AGAIN, WHERE WE'RE PRETTY MUCH AT CAPACITY FOR OUR STAFF AND SO ARE, ARE LOOKING TO EXPAND OUR TEAM AGAIN, UM, BECAUSE WE DO HAVE THOSE 60 KIDS ON THE WAIT LIST THAT WE NEED TO SERVE. 
          UM, SO JUST A LITTLE BIT ABOUT COUNTY REQUIREMENTS COMPLIANCE, SOME OF THAT INFORMATION FOR YOU. 
          UM, DHS DOES SAY THAT COUNTY SHOULD BE DOING CONTINUOUS ENROLLMENT, WHICH MEANS WE NEED TO BE ENROLLING KIDS WITHIN 45 DAYS OF ELIGIBILITY TO CLTS. 
          RIGHT NOW, WE'RE AT ABOUT A SIX TO NINE MONTH WAIT LIST. 
          UM, SO YOU CAN SEE WE WE'RE NOT MEETING THAT REQUIREMENT RIGHT NOW, AND THAT IS BECAUSE WE'RE AT CAPACITY AS FAR AS STAFF GO. 
          UM, SO THAT MEANS THAT WE DO HAVE TO DO SOME ADDITIONAL REPORTING AND JUST MEETINGS WITH DHS TO TALK ABOUT WHY AREN'T WE MEETING THAT. 
          UM, DHS CONTINUES TO SAY A LACK OF STAFF IS NOT A REASON TO HAVE A WAIT LIST. 
          SO WE ARE AT A POINT, YOU KNOW, WHERE WE NEED TO ADDRESS THAT AND DO SOMETHING. 
          UM, AND THERE IS A POTENTIAL FOR NON-COMPLIANCE CONSEQUENCES IN THE FUTURE. 
          I DON'T KNOW WHAT THAT MIGHT BE OR WHAT THAT WOULD LOOK LIKE. 
          UM, BUT IT IS POSSIBLE THAT IF WE DON'T HIT THOSE MARKS, THERE WOULD BE SOME SORT OF A CONSEQUENCE FOR US, UM, FROM A STATE PERSPECTIVE. 
          ALL RIGHT. 
          UM, HERE'S MY FAVORITE PART OF THIS PRESENTATION. 
          SO WE HAVE A COUPLE TESTIMONIALS FROM SOME OF OUR FAMILIES THAT HAVE PARTICIPATED IN THE PROGRAM AS WELL AS SOME PICTURES. 
          SO YOU CAN SEE SOME OF OUR KIDS, UM, AND WHAT THEY'VE BEEN ABLE TO BENEFIT FROM. 
          SO I'LL GIVE YOU A MINUTE. 
          I'M NOT GONNA READ EVERYTHING TO YOU, BUT I'LL GIVE YOU A MINUTE TO, UH, READ THROUGH SOME OF THESE TESTIMONIALS, UM, AND GET A SENSE OF WHAT FAMILIES REALLY GET WHEN THEY ARE IN THIS PROGRAM. 
          UM, AND THE IMPORTANCE OF THIS PROGRAM. 
          I, AND SO YOU CAN SEE WITH THIS ONE IN PARTICULAR, THIS MOM POINTS OUT A COUPLE THINGS THAT SHE SPECIFICALLY GOT RESPITE, EQUINE SWIM, UM, WHICH ARE COMMON ONES THAT WE SEE ACROSS FAMILIES. 
          AND THEN HERE'S ANOTHER ONE WHERE A FAMILY, AGAIN, IS TALKING ABOUT SPECIFICALLY THE SUPPORT THAT THEY'VE GOTTEN FROM THEIR CASEWORKER AROUND ACCESSING RESOURCES, HELPING WITH SOME FORWARD HEALTH, WHICH IS MEDICAID ISSUES. 
          UM, JUST MAKING SURE THAT A KID HAD WHAT THEY NEEDED. 
          AND THAT IS REALLY WHAT OUR CASEWORKERS DO IS, YOU KNOW, ANYTHING THAT A FAMILY NEEDS, THEY'RE GONNA TRY TO HELP THEM FIGURE THAT OUT. 
          ALL RIGHT. 
          AND THEN THE FUN PART IS SOME PICTURES OF SOME OF OUR KIDS THAT YOU GUYS CAN SEE. 
          UM, SO THESE ARE SOME EXAMPLES OF SOME OF THE THINGS THAT CLTS HAS FUNDED FOR SOME OF OUR KIDS IN OUR PROGRAM. 
          SO I, IT'S PROBABLY HARD TO SEE THIS FIRST GUY. 
          UH, HE HAS SOME PRETTY SIGNIFICANT MEDICAL NEEDS. 
          WE'VE GOT A FEEDING TUBES AND MEDICAL EQUIPMENT. 
          UM, SO WE WERE ABLE TO GET A BIKE TRAILER. 
          HE'S USUALLY USES A WHEELCHAIR, UM, BUT THEN HE'S ABLE TO SIT IN THAT COMFORTABLY, HAVE ALL OF HIS MEDICAL EQUIPMENT FIT IN THERE WITH HIM, UM, AND BE ABLE TO GO FOR BIKE RIDES AND BE OUT IN THE COMMUNITY AND BE OUT WITH HIS FAMILY. 
          UM, ANOTHER LITTLE GUY WHO'S DOING SOME EQUINE THERAPY, UH, WHICH IS A REAL COMMON ONE THAT WE DO, WHICH HAS BEEN REALLY COOL TO SEE. 
          UM, THIS, UH, ANOTHER KID WHO'S DOING SOME DANCE, HE'S, UH, WORKING ON SOME PHYSICAL THINGS AS WELL AS JUST SOCIALIZATION, BUILDING CONFIDENCE, ALL THOSE THINGS THAT COME ALONG WITH THAT. 
          UM, AND THEN YOU'LL SEE WE DO A LOT OF BIKES. 
          WE DO A LOT OF ADAPTIVE BIKES FOR KIDS THAT NEED HELP, UM, BEING ABLE TO RIDE A BIKE AND BEING ABLE TO DO SOME OF THOSE THINGS. 
          SO THIS IS ONE OF OUR KIDS IN HIS BIKE. 
          AND THEN THERE'S A COUPLE MORE BIKES. 
          THESE ARE BOTH KIDDOS THAT HAVE SOME PRETTY SIGNIFICANT PHYSICAL NEEDS, AND SO THEY NEED SOME SPECIALIZED BIKES TO BE ABLE TO HAVE THAT SUPPORT TO BE STRAPPED IN, TO BE ABLE TO SIT SAFELY. 
          UM, IT'S PROBABLY HARD TO SEE, BUT THERE'S LIKE A BAR IN THE BACK OF THESE BIKES, SO A PARENT OR A CAREGIVER CAN BE BACK THERE AND HELP STEER, MAKE SURE THAT THEY'RE GOING, BUT THEY GET THAT FEELING OF ACTUALLY RIDING A BIKE AND BEING ABLE TO DO THAT. 
          UM, AND THEN OUR LAST LITTLE KIDDO IS A SWING THAT HE GOT FOR SOME SENSORY NEEDS. 
          SO THEY USE A SWING INSIDE, OUTSIDE, 
          [01:10:01]
UM, AND CAN USE THAT TO HELP HIM REGULATE WHEN HE NEEDS THAT. 
          AND THAT IS, THAT'S IT. 
          ANY QUESTIONS THAT KELLY AND I CAN ANSWER? SO I HAVE A QUESTION, UM, RELATED TO THE WAIT TIME AND THE NUMBERS AS WASHINGTON COUNTY COMPARED TO THE OTHER COUNTIES THAT YOU DID WITH OUR, OUR WEIGHT AVERAGE OF 178 DAYS. 
          AND YOU COMMENTED, I WAS GONNA ASK THE REASON, BUT YOU COMMENTED ON THE YOU'RE AT AT CAPACITY WITH STAFF. 
          YES, CORRECT. 
          SO IS IS IT THAT YOU'RE AT CAPACITY FOR MULTIPLE REASONS BECAUSE IT'S VERY TIME INTENSIVE KIND OF WORK THAT YOU DO? IT SEEMS THAT WAY. 
          ARE YOU AT CAPACITY IN NUMBERS, UH, SIMPLY BECAUSE YOU HAVE DIFFERENT, UH, AREAS AND DIFFERENT DIVISIONS THEY'RE HELPING AND, AND DOING THEIR JOBS? HELP US UNDERSTAND. 
          I MEAN THE, THE OTHER ONE WITH THE OTHER COUNTIES IS AT A 58. 
          YEAH. 
          UM, SO I THINK THERE'S A FEW ANSWERS TO THAT. 
          OKAY. 
          UM, SO A TYPICAL CLTS CASELOAD IS 35 CASES, UM, WHICH MIGHT SEEM HIGH IF YOU'RE THINKING ABOUT MORE LIKE TRADITIONAL MENTAL HEALTH CASES WHERE THEY'RE DOING A LOT MORE HANDS-ON SERVICE, SINCE WE DO MORE AUTHORIZING SERVICE CONNECTION, WE CAN HAVE A LITTLE BIT HIGHER CASELOAD, BUT 35 IS, IS DOABLE. 
          UM, AND WE HAVE REALLY TRIED TO HAVE THAT BALANCE OF CLEARING THE WAIT LIST AS QUICKLY AS POSSIBLE AND NOT OVERLOADING OUR STAFF KNOWING THAT THAT'S GONNA LEAD TO TURNOVER AND BURNOUT AND NOT HIGH QUALITY SERVICES BECAUSE PEOPLE AREN'T GONNA HAVE THE TIME AND THE ENERGY TO DO THAT. 
          SO OUR CURRENT STAFF ARE JUST ABOUT MAXED OUT AS FAR AS HAVING THAT 35 CASELOAD, UM, AVERAGE. 
          UM, WE ALSO, LIKE REFERRALS HAVE JUST INCREASED, I THINK MORE THAN ANYONE ANTICIPATED, BOTH US INTERNALLY AT THE COUNTY AND STATEWIDE. 
          UM, SO WE'VE SEEN LOTS, I CAN SPEAK SORT OF, UH, NOT VAGUELY ABOUT OTHER COUNTIES, BUT I KNOW A LOT OF OTHER, IT WAS A, FOR EXAMPLE, CONTRACTED OUT FOR SOME CLTS SERVICES. 
          SO THEY HAVE EXTERNAL STAFF AS WELL AS INTERNAL, AND I THINK THEY ADDED, I THINK THEY'RE UP TO ALMOST 10 STAFF NOW, UM, CONTRACTED. 
          SO I MEAN, THEY ARE KIND OF EQUIVALENT TO US AND THAT IS WHERE THEY'RE AT AND WHAT THEY NEED. 
          UM, YOU KNOW, DOUG COMES FROM WINNEBAGO COUNTY, SO WE SOMETIMES HAVE A READ ON WHAT THEY'RE DOING UP THERE, AND I KNOW THEY HAVE DONE THE SAME THING AS FAR AS ADDING AND BEING ABLE TO ACCOMMODATE THAT EXTRA STAFF, BUT IT IS SOMETHING A LOT OF OTHER COUNTIES WHO DIDN'T HAVE WAIT LIST PREVIOUSLY ARE GOING TO WAIT LIST NOW BECAUSE THEY ARE CAPPED OUT AS WELL. 
          UM, SO THERE'S A LOT OF REASONS FOR THAT, BUT IT IS, IT'S A, IT'S A CAPACITY ISSUE IS WHAT IT BOILS DOWN TO. 
          AND THE INCREASED AWARENESS YOU THAT IT REALLY TOOK OFF WITH WITH SOCIAL MEDIA AND WORD OF MOUTH AND EXACTLY. 
          SO I GET THAT, BUT WE, IT, ESPECIALLY IF THERE ARE GONNA BE PENALTIES, IT, IT WOULD APPEAR WE NEED TO DO SOMETHING . 
          YEAH, DEFINITELY. 
          AND IN THE PAST, YOU KNOW, THERE USED TO BE YOU WOULD WAIT YEARS TO GET INTO CL TS, YOU KNOW, IT WOULD BE AN AVERAGE OF THREE, FOUR YEARS TO GET INTO PROGRAMMING. 
          AND SO I THINK A LOT OF FAMILIES WHO WERE SORT OF ON THE EDGE AND DIDN'T NEED A LOT WOULD JUST SAY, OH NO, IT'S NOT WORTH IT, NEVERMIND. 
          WHERE NOW WITH THE SHORTER WAIT TIME, THEY'LL SAY, YEAH, LIKE, WE DO WANNA COME IN AND WE DO WANNA BENEFIT FROM SERVICES. 
          SO WE'RE GETTING A LOT MORE IN. 
          AND THEN BECAUSE WE SERVE THE WHOLE CHILDHOOD, WE DON'T HAVE KIDS AGE OUT OR LEAVE THE PROGRAM IN THE SAME WAY. 
          SO WE KIND OF GET INTO THAT POINT WHERE WE GET STAGNANT. 
          OKAY. 
          THANK YOU FOR THOSE ANSWERS. 
          ANY OTHER QUESTIONS, SUPERVISOR BOSSERT? SO IT LOOKS LIKE THIS IS MOSTLY FULLY, WE'RE GONNA RECOUP MOST OF THE FUNDS OF THIS AS IT IS WITH THE REIMBURSEMENTS FROM MEDICAID. 
          AND I THINK ABOUT THE FAMILIES WE'RE SERVING, A LOT OF THEM ARE NOT THE TRADITIONAL LOW INCOME FAMILIES. 
          THEY'RE FAMILIES THAT, YOU KNOW, BOTH PARENTS WORK, THEY PAY TAXES, SO WE WANNA MAKE SURE WE'RE SERVICING THEM WELL. 
          SO YEP, THAT'S, THAT'S KIND OF MY IMPRESSION AND READ OF THIS. 
          SO IN MY VIEW, THIS MAKES SENSE TO DO IT, SO, YEAH. 
          YEAH. 
          AND I THINK JULIE PROVIDED IN SOME OF THE, UH, DOCUMENTATION FOR YOU GUYS THAT YEAH, LIKE WE DO BILL ALL OF OUR CASE MANAGEMENT TIME. 
          MM-HMM. 
          . 
          SO WE ARE ABLE TO RECOUP THAT AND BALANCE OUT THE COST OF, OF A POSITION, UM, MOST OF THE TIME. 
          MM-HMM,  AND IT'S INCREASED YOUR, UH, REIMBURSEMENT RATE, CORRECT. 
          OVER YES. 
          YEP. 
          WE'VE DONE LOT OF WORK TO, TO INCREASE THAT RATE. 
          AND DHS ENCOURAGES YOU TO DO THAT AND TO MAKE SURE THAT YOU DO ACCOUNT, BECAUSE OBVIOUSLY WE KNOW WHEN A STAFF WALKS IN THE DOOR, WE CAN'T GIVE THEM 35 CASES ON DAY ONE. 
          IT TAKES SOME TIME FOR THEM TO GET UP TO THAT FULL CASELOAD AND TO BE ABLE TO BILL AT THAT RATE. 
          UM, SO WE CAN BUILD SOME OF THAT, YOU KNOW, UH, PREP TIME OR, YOU KNOW, TRAINING TIME INTO OUR RATE PROFESS GALLES. 
          UM, SO, SO THE, THE, THE COMMENT ABOUT THE, THE, THE FUNDING AND IT SPOKE TO THE ADDITIONAL CASE MANAGEMENT REIMBURSEMENT RATE, I THINK IN PART OR FULL. 
          SO HOW LIKELY WILL THAT INCREASE 
          [01:15:01]
REVENUE REMAIN? YOU KNOW, WE HAD A PREVIOUS, UH, AGENDA TOPIC ITEM ABOUT MEDICARE REIMBURSEMENT RATE BEING SET BY THE STATE AND CAN FLUCTUATE. 
          SO IF THAT WERE TO GO DOWN, WHAT'S THE IMPACT? UM, IF IT WERE TO GO UP , IT'S NOT AN ISSUE, BUT IF IT WERE TO GO DOWN, YEAH. 
          AND, UM, YEAH, THAT BETTER THAN ME. 
          LET ME PUNT ON THAT ONE. 
          SO, UM, I, I WOULD SAY AS IN 2018 WHEN WE WERE MANDATED TO ELIMINATE OUR WAIT LIST AND STARTED THIS, THIS ESSENTIALLY PROCESS, RIGHT, OF GROWING THIS PROGRAM TO MEET THIS EVER-GROWING WAIT LIST. 
          AND AS YOU CAN TELL EVEN OUR OWN PROJECTIONS, WE'VE OUT, WE'VE OUTPACED OUR OWN PROJECTIONS. 
          UM, THE LAST TWO YEARS AGO WHEN WE CAME FOR CASE MANAGER POSITIONS, WE THOUGHT WE WOULD SERVE 230 AND WE'RE SERVING 70 MORE THAN THAT. 
          UM, AND PART OF, UM, OUR ISSUE AT THE TIME, UM, I WOULD SAY BACK IN 2018 WAS THE REIMBURSEMENT RATE. 
          AND SO THE STATE HAS DONE A LOT OF WORK WITH THE COUNTIES, UM, TO MAKE SURE THAT THE WAY THAT WE'RE, WE'RE CREATING OUR RATE, UM, REALLY TAKES ALL COSTS INTO EFFECT. 
          AND SO AT THIS POINT, BECAUSE OF THEIR COMMITMENT, AND I THINK IT'S, IT'S ALSO BECAUSE OF REQUIREMENTS THAT THE STATE HAS FROM THE FEDERAL GOVERNMENT, UM, TO MAKE THIS A FULLY FUNDED PROGRAM, THE RATE SETTING WILL CONTINUE. 
          AND WHAT WE'VE SEEN IS THAT AS OUR STAFF SALARY GROWS, THEN OUR RATE WILL BE READJUSTED BASED ON OUR ACTUAL COSTS. 
          AND SO WHAT'S A LITTLE BIT DIFFERENT IN THIS PROGRAM THAN A DIFFERENT MEDICAID PROGRAM WHERE THE STATE OR THE MEDICAID PROVI, MEDICAID JUST SAYS, THIS IS THE RATE, WE ARE ABLE TO PROVIDE A COST ANALYSIS TO SET OUR RATE. 
          AND SO, UM, I BELIEVE IT'S IN THE REPORT, BUT TWO YEARS AGO OUR RATE WAS 20, ABOUT $20 LESS AN HOUR, UM, BECAUSE THAT WAS BASED ON OUR COSTS THEN. 
          UM, AND SO BASED ON OUR COSTS NOW, UM, THAT RATE WENT UP. 
          AND SO AS WE CONTINUE, OBVIOUSLY WE WANNA RETAIN OUR STAFF AND THEY CONTINUE TO GET RAISES, WE'LL BE ABLE TO ADJUST OUR RATE AS WELL. 
          UM, AND SO THAT'S WHAT MAKES THIS JUST A LITTLE BIT DIFFERENT THAN, UM, OTHER MEDICAID RATE SETTING. 
          AND AS A CONSEQUENCE, JULIE, ANY IDEA OF WHAT THE PENALTIES COULD BE? HAVE YOU HEARD OR SEEN OTHER COUNTIES BE PENALIZED FOR? NO, UM, , I, I, NOT THAT I'M AWARE OF, BUT NOT THAT I'VE HEARD FROM SARAH AND KELLY. 
          UM, I THINK THE LAST, UM, TWO YEARS AGO WHEN WE CAME FORWARD WITH THE OTHER, FOR THE OTHER POSITIONS, UH, WE HAD RECEIVED A LETTER AT THAT POINT. 
          UM, AND SO, UM, RIGHT NOW THEY'RE JUST SORT OF TEETERING AROUND THAT CONVERSATION. 
          UM, I, I, I, YOU KNOW, I'M ALSO HARD PRESSED TO SAY LIKE, OH, I MEAN, WHO, YOU KNOW, WHAT ARE YOU GONNA DO IF WE DON'T DO THIS WORK? BUT, UM, BUT OBVIOUSLY THEY WANT US TO MAKE, YOU KNOW, MAKE THE EFFORTS. 
          THERE'S KIDS WHO NEED SERVICES, WE DON'T WANT THEM WAITING ON THE WAIT LIST. 
          AND I WOULD SAY FOR US INTERNALLY, YOU KNOW, AND, AND THE REASON WE'RE DOING SUCH A BIG PRESENTATION IS 'CAUSE I RECOGNIZE THAT THIS IS A HUGE ASK. 
          WE'RE GROWING OUR PROGRAM AND OUR, UM, DEPARTMENT BY THREE POSITIONS THAT WILL HAVE ONGOING, YOU KNOW, IMPACT TO, TO THE COUNTY. 
          UM, AND, BUT WE WERE, WE'RE AT THAT PLACE WHERE WE CAN'T ADD MORE STAFF WITHOUT ANOTHER SUPERVISOR. 
          AND SO THAT'S WHY THIS MAKES THIS, UM, I THINK WE WERE, UM, A LITTLE DELAYED IN BRINGING THIS FORWARD BECAUSE WE WERE TRYING TO FIGURE OUT A, THE MATH, MAKE SURE THE MATH WORKED. 
          UM, I HAD TO HAVE REAL, REAL, UH, FINANCE PEOPLE DO THAT FOR ME. 
          UM, AND SO, UM, SO THAT WAS A, A BIT OF OUR WORK. 
          UM, AND ALSO, YOU KNOW, AS SARAH AND KELLY HAVE BEEN ADDING POSITIONS AND WE HAVE HAD TURNOVER, I MEAN, THAT'S JUST ALSO PART OF, YOU KNOW, OF THE WORK. 
          UM, YOU KNOW, THEY'VE BEEN TRYING TO ASSESS LIKE, WHERE CAN WE REALLY GET AT WITH THE STAFF THAT WE HAVE? BUT THEN THESE, THESE ADDITIONAL REFERRALS HAVE JUST BEEN COMING, UM, IN A QUICKER PACE THAN WE REALLY ANTICIPATED. 
          AND SO WE'VE BEEN IN THIS LITTLE BIT OF A STUDYING SPACE, UM, AND WE REALLY JUST NEED TO MOVE, RIGHT? SO, WHICH IS WHERE WE MADE THE DECISION OF, YOU KNOW, WE'RE JUST GONNA ASK FOR THE, ALL OF THAT WE NEED, UM, SO THAT WE CAN GET THESE KIDS OFF THE WAIT LIST AND HOPEFULLY GET TO, UM, SORT OF A STATUS QUO. 
          UM, YOU KNOW, THAT WE'RE NOT JUST, YOU KNOW, KEEP GROWING AND GROWING AND GROWING, BUT YOU KNOW, I MEAN, MAYBE THE END NUMBERS INDICATE THAT THAT'S A POSSIBILITY, BUT AT LEAST WE WANT TO SERVICE THE KIDS THAT ARE KNOWN AND ON THE WAIT LIST NOW, MM-HMM. 
           SUPERVISOR GELS, UH, THANK YOU, UM, TO, UH, SUPERVISOR BAER'S COMMENT. 
          YEAH, IT, IT'S DOING THE RIGHT THING FOR THESE CHILDREN, FOR THE PARENTS, UH, COUNTY RESIDENTS AND THAT I HAVE NO ISSUE WITH THAT. 
          AND, AND MAYBE TO SUPERVISOR SCHULTE, I'M LEARNING AND I'M NOT FULLY, UH, UM, AWARE, BUT JUST MATHEMATICALLY, SO MY QUESTION ABOUT 
          [01:20:01]
THE ADDITIONAL SUPERVISOR AND THE NEED FOR THAT, IS IT BECAUSE OF A LOT, UH, OF INTENSITY THAT'S REQUIRED BY THE SUPERVISOR WITH THE CASE MANAGER THAT CREATES THAT TIPPING POINT, UH, UH, AS STATED, UM, BECAUSE 11 AND THREE MANAGERS OR SUPERVISORS, THAT'S ALMOST FOUR TO ONE, 3.7 OR WHATEVER TO, TO ONE. 
          SO I, I'M JUST TRYING TO UNDERSTAND, FULLY UNDERSTAND AND, UH, AND, AND AGREE AND SUPPORT, UH, THAT THE RATIO FOR, AND THE, THE JUSTIFICATION, IF YOU CALL IT FOR THE CASE MANAGER, I'M JUST TRYING TO, UH, UNDERSTAND THE ADDITIONAL SUPERVISORY POSITION. 
          SURE. 
          UM, AND SO I KNOW WE GAVE YOU A LOT OF INFORMATION TODAY, UM, AND THE POWERPOINT WAS NOT IN YOUR PACKET. 
          UM, AND SO, UM, WHAT IS ALSO, UM, TO MAKE SURE THAT YOU GUYS FULLY UNDERSTAND IS THAT CLTS IS JUST ONE OF THE PROGRAMS THAT KELLY AND SARAH OVERSEE IN THE YOUTH TREATMENT TEAM. 
          AND SO THEY ALSO OVERSEE OUR COMPREHENSIVE COMMUNITY SERVICES PROGRAM, WHICH, UM, IS A PROGRAM FOR CHILDREN WHO HAVE BEHAVIORAL AND MENTAL HEALTH NEEDS. 
          UM, WE CON BECAUSE THAT IS, THAT CAN BE BILLED AT A FEE FOR SERVICE, UM, BASIS. 
          WE CONTRACT THAT OUT, BUT THEY STILL HAVE TO OVERSEE ALL OF THEIR WORK OF THOSE CASE MANAGERS AND THE COMPLIANCE OF THAT PROGRAM AS WELL AS, UM, THE ANCILLARY SERVICE CONTRACTS. 
          THEN WE ALSO HAVE OUR FAMILY CENTER TREATMENT, UM, PROGRAM. 
          FOR THOSE OF YOU WHO WERE NOT ON OUR COMMITTEE LAST, THE LAST, UM, TWO YEARS, THAT WAS ONE OF OUR STRATEGIC PRIORITY, UM, INITIATIVES. 
          UM, AND THAT IS CONNECTED TO WHAT CORAL PRESENTED EARLIER. 
          UM, BUT THAT IS A VERY INTENSIVE, UM, IN-HOME THERAPEUTIC INTERVENTION AIMED AT KEEPING KIDS IN THEIR HOME AND NOT IN OUT-OF-HOME CARE, WHICH FOR THOSE OF YOU WHO ARE NEW, IS THE BIGGEST DRIVER OF COST FOR HUMAN SERVICES. 
          AND SO, UH, THAT IS A VERY INTENSIVE PROGRAM. 
          KELLY ALSO OVERSEES THAT PROGRAM IS ALSO, UM, UH, TRAINED, UH, TRAIN THE TRAINER TRAINED, UM, AND HAS, THEY WENT THROUGH A YEAR AND A HALF LONG INTENSIVE PROCESS TO BECOME, UM, TO, FOR THE FIDELITY OF THAT PROGRAM AND TO BECOME, UM, TO THE LEVEL OF SERVICE THAT WE'RE PROVIDING. 
          AND ALSO THEN THERE'S THE BIRTH TO THREE. 
          WHILE THRESHOLD DOES THE BULK OF THAT WORK, THERE IS STILL, UM, OVERSIGHT AND, AND CONTRACTUAL WORK TO THAT. 
          SO, UM, THAT IS WHERE THE, THE SUPERVISORY TIPPING POINT COMES BECAUSE THERE'S FOUR PROGRAMS IN THE YOUTH TREATMENT TEAM. 
          THANK YOU. 
          SUPERVISOR BOSER. 
          UM, KIND OF GO CIRCLING BACK TO THE PENALTIES. 
          I'M GUESSING THE STATE WOULD FACTOR IN THE GROSS WE'VE SEEN IN OUR PROGRAM AND THE GOOD FAITH EFFORTS WE'RE MEETING WE'RE WORKING ON TO TRY TO MEET THAT GROWTH IN ANY PENALTY DECISION OR VICE VERSA IF WE WEREN'T TRYING TO MEET THAT GROWTH THAT WOULD INCREASE THE LIKELIHOOD OF PENALTIES. 
          IS THAT KIND OF THE SENSE YOU HAVE AS WELL? UM, YEAH. 
          I WOULD SAY IN THE PAST, OH, SORRY. 
          UM, I WOULD SAY IN THE PAST WHEN WE  , UM, WHEN WE'VE HAD THOSE KINDS OF CONVERSATIONS WITH THE STATE AROUND, YOU KNOW, WE STILL ARE NOT ELIMINATING THE WAIT LIST, WE'RE STILL NOT MEETING THOSE REQUIREMENTS. 
          A LOT OF THAT IS, OKAY, WHAT ARE YOU DOING? YOU KNOW, YOU NEED TO REPORT TO US WHAT YOU'RE DOING AND HOW YOU'RE ACCOMMODATING THIS. 
          UM, SO, SO FAR THAT THEY HAVE TAKEN THAT INTO ACCOUNT, I THINK THAT REFERRALS HAVE EXCEEDED THEIR EXPECTATIONS AS WELL. 
          YOU KNOW, THEY HAD SORT OF HAD A GENERAL TIMELINE FOR WHEN THEY THOUGHT COUNTIES WOULD BE ABLE TO CLEAR WAIT LISTS. 
          UM, AND THERE'S OTHERS THAT WE'VE NOT MET THAT. 
          SO I THINK THAT THAT'S WHY THEY HAVE BEEN A LITTLE LENIENT ON SOME OF THAT. 
          UM, BUT THAT THEY CERTAINLY DO HAVE TAKEN THAT INTO CONSIDERATION IN THE PAST. 
          SO I WOULD HOPE THAT THAT WOULD CONTINUE IN THE FUTURE. 
          ALL RIGHT. 
          THANK YOU. 
          AND I WOULD JUST ADD TO THAT, I MEAN, YES, THEY ARE, THEY, THEY WANT US TO JUST BE SUCCESSFUL. 
          SO THEY'RE, UM, THEY HAVE, YOU KNOW, THEY'RE TRYING TO WORK WITH US, BUT I THINK IF WE WERE TO GET TO A POINT WITH THEM WHERE WE JUST SET LIKE, WE KNOW WE'RE NOT DOING IT RIGHT, THEN THEY WOULD. 
          UM, BUT YOU CAN ONLY SORT OF KICK THE CAN DOWN THE ROAD FOR SO LONG WITH THEM. 
          YEAH. 
          ANY OTHER QUESTIONS? OKAY. 
          THANK YOU VERY MUCH. 
          THANK YOU. 
          I THINK THIS, UH, NEEDS A MOTION. 
          NO, WE HAVE IT. 
          WE JUST NEED TO VOTE. 
          YEP. 
          YEP. 
          ALL THOSE IN FAVOR OF, UM, PASSING THE RESOLUTION FOR CHILDREN'S LONG-TERM SUPPORT CASE MANAGER POSITION. 
          ALL IN FAVOR SAY AYE. 
          AYE. 
          AYE. 
          OPPOSED? ALL RIGHT, IT PASSES. 
          THANK YOU. 
          OUR NEXT MEETING DATE IS WEDNESDAY, JUNE 26TH. 
          THAT 4:00 PM THIS MEETING IS ADJOURNED.
* This transcript was created by voice-to-text technology. The transcript has not been edited for errors or omissions, it is for reference only and is not the official minutes of the meeting.