public health and human services board - 19 mar 2019 · 2019. 3. 14. · assistance programs. these...

AGENDA

Public Health and Human Services Board

8:30 AM - Tuesday, March 19, 2019

Commissioners Board Room

. CALL TO ORDER 2. PROCLAMATIONS A. March 2019 - Social Work Month

Social Work Appreciation Month 2019 Proclamation

3

B. April 2019 - Child Abuse Prevention Month

April is Child Abuse Prevention Month Proclamation 2019

5

3. APPROVAL OF CONSENT AGENDA

Motion to approve as a whole

A. Meeting Agenda B. Minutes

Public Health and Human Services Board - 19 Feb

7 - 13

C. Financial Report

PHHS Financial Report YTD 2-28-19

15 - 24

D. Abstracts and Bills 4. STAFF REPORT A. Heidi Akins and Reed Watson - Child Abuse Prevention 5. DIRECTORS REPORT A. Staff Updates B. Agency Updates 6. ITEMS FOR BOARD ACTION A. Approval of Addendums to Master Agreement with Sawtooth Mountain Clinic

• Child and Teen Check-Up

• Outreach

• SHIP

• WIC

• WIC Peer Breastfeeding

• Universal Family Home Visiting (new) 2018-19 SMC Addendums

25 - 40

B. Cook County Burial Policy Revisions

DRAFT Burial Application Packet

DRAFT Burial Determination and Appeal

41 - 51

7. COMMITTEE REPORTS A. Arrowhead Economic Opportunity Agency - Myron Bursheim (Primary), Ginny

Storlie (Alternate)

B. Arrowhead Health Alliance Joint Powers - Dave Mills (Primary), Heidi Doo-Kirk

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(Alternate)

C. Arrowhead Regional Corrections - Robert Deschampe (Primary), Myron

Bursheim (Alternate)

D. Arrowhead Regional Development Council - Ginny Storilie E. Community Health Board - Dave Mills F. Public Health and Human Services Advisory Committee - Jerry Lilja and Carla

LaPointe

G. Health Care Planning Committee - Ginny Storlie (Primary), Dave Mills

(Alternate)

H. North Shore Collaborative - Dave Mills (Primary), Heidi Doo-Kirk (Alternate) I. Emergency Preparedness Committee - Ginny Storlie, Myron Bursheim J. Board Comments for the Good of the Order – all 8. ADJOURNMENT

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Social Work Appreciation Month 2019 Proclamation

WHEREAS, the Social Work Profession is dedicated to enhancing well-being and helping meet the basic needs of all people, especially those who are vulnerable, oppressed and living in poverty;

WHEREAS, Social Workers elevate and empower people, giving them the ability to solve problems, cope with personal roadblocks and get the resources they need to succeed.

WHEREAS, the Social Work profession is deeply weaved into our society with social workers active in government, schools, universities, social service agencies, communities, corporations, the military and in health care and mental health care settings;

WHEREAS, Social Workers stand ready to help our society overcome current pressing issues, including equal rights for all, the need for improved availability of health care and mental health services;

NOW THEREFORE, in recognition of the numerous contributions made by Social Workers, I Heidi Doo-Kirk, Public Health and Human Services Board Chair proclaim the month of March 2019 as Social Work Month in Cook County and call upon all citizens to join Cook County Public Health & Human Services in celebration and support of the Social Work Profession.

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April Child Abuse Prevention Month Proclamation 2019

WHEREAS, in Federal fiscal year 2017, 4.1 million referrals were made to child protective services involving approximately 7.5 million children; and WHEREAS child abuse and neglect is a serious problem affecting every segment of our community, and finding solutions requires input and action from everyone in our community; and WHEREAS, our children are our most valuable resources and will shape the future of the State ofMinnestoa; and WHEREAS, child abuse can have long-term psychological, emotional, and physical effects that can have lifelong consequences for victims of abuse; and WHEREAS, protective factors are conditions that reduce or eliminate risk and promote the social, emotional, and developmental well-being of children; WHEREAS, effective child abuse prevention activities succeed because of the meaningful connections and partnerships created between child welfare, education, health, community- and faith-based organizations, businesses and law enforcement agencies; and WHEREAS, communities must make every effort to promote programs and activities that benefit children and their families; WHEREAS, we acknowledge that we must work together as a community to increase awareness about child abuse and contribute to promote the social and emotional well-being of children and families in a safe, stable, nurturing environment. WHEREAS, Prevention remains the best defense for our children and families; NOW, THEREFORE, I, Heidi Doo-Kirk, Public Health and Human services Board Chair, do hereby proclaim April,2019 as NATIONAL CHILD ABUSE AND NEGLECT PREVENTION MONTH in Cook County, Minnesota, and urge all citizens to recognize this month by dedicating ourselves to the task of improving the quality of life for all children and families.

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MINUTES

Public Health and Human Services Board

8:30 AM - Tuesday, February 19, 2019

Commissioners Board Room

The Public Health and Human Services Board of the Cook County was called to order on Tuesday, February 19, 2019, at 8:30 AM, in the Commissioners Board Room, with the following members present:

PRESENT: Commissioner Ginny Storlie, Commissioner Myron Bursheim, Commissioner Heidi Doo-Kirk, Commissioner Robert Deschampe, Member Carla LaPointe, Member Jerry Lilja, and Commissioner David Mills

EXCUSED:

ALSO PRESENT:

County Administrator Jeff Cadwell, Director Alison McIntyre, and Executive Administrative Assistant Sara Hadley

1 CALL TO ORDER

2 APPROVAL OF CONSENT AGENDA a) Meeting Agenda

RES-1-2019

Myron Bursheim made a motion to approve the February 2019 agenda. Ginny Storlie seconded the motion. CARRIED. unanimously.

b) January 15th, 2019 Meeting Minutes

RES-2-2019

Myron Bursheim made a motion to approve the January 2019 Minutes. Ginny Storlie seconded the motion. CARRIED. unanimously.

c) Financial Report

RES-3-2019

Myron Bursheim made a motion to approve the financial report. Ginny Storlie seconded the motion. CARRIED. unanimously.

d) Abstracts and Bills

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RES-4-2019

Myron Bursheim made a motion to approve the February 2019 Abstracts and Bills. Ginny Storlie seconded the motion. CARRIED. unanimously.

e) 2019 Purchase of Service Contract with Arrowhead Economic Opportunity Agency (AEOA) for MFIP and DWP Employment and Training and Family Stabilization Case Management Services

The contract with AEOA is a standing contract that is being renewed. The services the county has purchased are employment services. This is a mandated service provided to PHHS clients on MFIP and DWP cash assistance programs. These services include job coaching and resume building. The county receives an allocation from the state, then a portion of the funds are allocated to AEOA to provide this service.

RES-5-2019

David Mills made a motion to approve the 2019 AEOA Purchase of Service Agreement. Jerry Lilja seconded the motion. CARRIED. unanimously.

f) Temporary Employment Agreement for a Case Manager

RES-6-2019

Myron Bursheim made a motion to approve the temporary employment contract. Ginny Storlie seconded the motion. CARRIED. unanimously.

g) Children’s Mental Health Screening Grant

RES-7-2019

Myron Bursheim made a motion to approve the Children's Mental Health Screening Grant. Ginny Storlie seconded the motion. CARRIED. unanimously.

3 INTRODUCTION OF NEW STAFF a) KathyAnn Travis, Eligibility Specialist

McIntyre Introduced Travis to the Board. Travis then told the board about herself and thanked the board for the opportunity.

4 STAFF REPORT a) Staff Presentation: Early Childhood Services – Grace Bushard, Children

and Family Services Supervisor and Grace Grinager, Public Health Coordinator

Bushard and Grinager discussed services for early childhood development in Cook County. Early childhood development includes both physical and mental health. Grinager looks at preventative aspects of child development through the Public Health lens, and the Children and Family Services team supervised

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by Bushard, are tasked with responding to needs. Bushard and Grinager gave a PowerPoint Presentation on the importance of early childhood development services.

Grinager shared that a study conducted in the 1970s surveyed children as they grew into adults. The study showed a correlation between ACES (Adverse Childhood Experiences) and how the adults lived later in life. There was a community training in January in Grand Marais regarding ACES that generated a lot of interest. Bushard added that there is a national movement to increase resiliency. For example, Stearns County discovered that domestic abuse was their highest risk area. So, they have embedded two social workers within Law Enforcement. The social workers work with families to build on resources that the family already has and try to focus on their strengths. Grinager added that ACES focuses on the individual child, but there is also a community level that needs to be addressed in order to support children. One community issue is child care. If parents are struggling to find child care, they may not be able to work, and this could cause financial stress. Not having adequate child care in the community is one way that young families struggle. Grinager added that we can think of childcare as infrastructure for the community. There have been longitudinal studies that discovered that the return on early childhood investment is $7 for every $1 invested. Often social services and public health are having to show the difference they make.

Cook County PHHS offers financial assistance programs (i.e. SNAP, MFIP, Health Care, Child Care Assistance Program), WIC, advocacy for the child and coordination of services, PSOP (Parent Support Outreach Program), child protection and welfare, mental health case management, the Follow Along Program, and referrals and collaboration with other entities in the community. Grinager quoted John Bowlby and stated, “If we want to support children, we need to cherish parents.”

Commissioner Storlie shared that she found Early Childhood Family Education (ECFE) supportive to parents and asked if it is still active. Bushard and Grinager shared that the program is still active and is run through the school district. Lilja commented that it could be difficult for families to self-identify for the PSOP program. Bushard stated that sometimes the department will get a maltreatment report, but it doesn’t meet criteria for child protection and if needs are identified the worker can reach out to the family to see if they are interested. To qualify for PSOP the child must be under ten.

Commissioner Mills asked if there are any programs in our community that encourage midwifery or the childbirth education. Grinager stated that the department contracts with the clinic to support childbirth education, but the department does not currently a midwife practicing home births. She added that there could be additional support to help with the added stress of travel. There is an idea that supporting women during pregnancy gives her the power to support the child after it is born. Also supporting parents in the immediate transition into parenthood is very important. Commissioner Doo-Kirk asked how these programs cam be measured to see if they are working. Grinager shared that often other studies that have happened on a larger scale have to be relied on. Often times one has to use best practices and their own judgement.

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https://www.co.cook.mn.us/index.php/human-services-documents/child-development-power-point

https://www.cdc.gov/violenceprevention/childabuseandneglect/acestudy/index.html

https://mn.gov/dhs/people-we-serve/adults/economic-assistance/food-nutrition/programs-and-services/supplemental-nutrition-assistance-program.jsp

https://mn.gov/dhs/people-we-serve/children-and-families/economic-assistance/income/programs-and-services/mfip.jsp

https://mn.gov/dhs/people-we-serve/adults/health-care/health-care-programs/

https://mn.gov/dhs/partners-and-providers/policies-procedures/child-care-and-early-education/child-care-assistance-program/

https://www.fns.usda.gov/wic/women-infants-and-children-wic

https://mn.gov/dhs/people-we-serve/children-and-families/services/child-protection/programs-services/parent-support-outreach.jsp

https://www.health.state.mn.us/people/childrenyouth/fap/index.html

https://www.health.state.mn.us/people/childrenyouth/fap/index.html

https://www.cookcountyschools.org/index.php/communityed/ecfe-2019-winter-registration-information/viewdocument

Bushard stated that many times the effects of these programs are not immediate. She stated that there had been some research with the PSOP program. After the research less than half of the families were involved in child protection.

5 DIRECTORS REPORT a) Staff Updates

McIntyre shared that KathyAnn Travis is filling the vacancy left by Pat Strand. She will attend training in St. Paul for SNAP then will go on to learn other programs including long-term care health care programs.

The Adult Services Social Worker interviews were held last week, and there were four interviewees. The department will present a recommendation the board at the next regular Board meeting.

b) Agency Updates

The Community Health Assessment meeting was rescheduled due to the extreme cold. It will be held on February 25th from 1-3 PM in the Commissioners Board Room. An organizational meeting to establish a local mental health advisory council will be held on Thursday to review draft bylaws and the membership application. A subcommittee of the PHHS Advisory Committee will participate in this meeting.

McIntyre added the legislative session is underway. This week the senate bill related to the Child Protection funding withholds will be discussed. The withholds are a product of the Governor's Taskforce on Child Protection, which gave additional funding to county human services departments to meet the requirements for screening and response that were established in 2015. 20% of these funds allocated to counties have to be earned by meeting performance standards. This funding system is detrimental to small counties, and one family could skew the results of the needed performance standards. Funding for children’s residential treatment centers is set to expire as well. Without this funding counties would be responsible for 100% of these cost of care. She added that the Governor’s budget is set to be released this week as well.

McIntyre shared that she had received letters from some of the applicants of the Public Health Community Fund and included these with Board materials. The Oral Health Task Force and Violence Prevention Center both had submitted letters. McIntyre wished to recognize the contributions of these organizations

McIntyre stated that the department is looking ahead at staff presentations for the upcoming year. She asked that if the Board has suggested topic areas, or anything that they would like to learn more about to contact her and let her know. Commissioner Doo-Kirk suggested adding the 2019 PHHS Board Staff Presentation Calendar to the minutes.

McIntyre thanked the board for allowing her to add the new item for board action. The request before the Board is for permission to move forward with identifying a party interested in providing community support services. This

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https://www.co.cook.mn.us/index.php/human-services-documents?task=document.viewdoc&id=528

https://www.co.cook.mn.us/index.php/human-services-documents?task=document.viewdoc&id=528

contract position will help to fill the gaps created by the closure of HDC in November. This position will help to provide support services for adults living with mental illness. The department is looking to move forward with identifying individuals who qualified to provide this service. This is a temporary contract position which will allow the department to meet some of the immediate and acute gaps while allowing time for long term planning.

c) d)

6 ITEMS FOR BOARD ACTION a) Approval to move forward to identify a person for contracted, temporary

Community Support Worker position.

Commissioner Storlie asked if this position would receive benefits. McIntyre stated that this person would not, as it is a contract position. Commissioner Bursheim asked if the funds for this position are in the budget. McIntyre explained that the department will be using funds that were historically allocated to HDC to provide this service. There is revenue in the budget to cover this position. Lilja asked who this person would report to. McIntyre shared that this person would be a part of the Child and Family Services team and would report to Grace Bushard or herself. This position would work closely with PHHS' Adult and Children's Mental Health Case Managers who receive clinical supervision from Sawtooth Mountain Clinic. Commissioner Deschampe asked how many clients were served by HDC. McIntyre stated the department received reports on number of clients served while they were in the process of closing their office and it is hard to say as HDC's staffing capacity decreased in recent years.

RES-8-2019

David Mills made a motion made a motion to approve the moving forward in order to identify a person for contracted, temporary Community Support Worker position. Myron Bursheim seconded the motion. CARRIED. unanimously.

7 COMMITTEE REPORTS a) Arrowhead Economic Opportunity Agency - Myron Bursheim (Primary),

Ginny Storlie (Alternate)

Did not meet. b) Arrowhead Health Alliance Joint Powers - David Mills (Primary), Heidi

Doo-Kirk (Alternate)

Has not meet. Mills shared that hemet with Ric Shafer to learn about the AHA. There may be a change in which the employees work with ARDC, but nothing has been decided at this time.

c) Arrowhead Regional Corrections - Robert Deschampe (Primary), Myron Bursheim (Alternate)

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Met Friday and elected board chairs. d) Arrowhead Regional Development Council - Ginnie Storilie

Nothing to report. e) Community Health Board - Heidi Doo-Kirk

The group did not have a quorum and had technical problems connecting to the meeting in Duluth.

f) Public Health and Human Services Advisory Committee - Carla LaPointe and Jerry Lilja

Did not meet. Next meeting is March 5th and the co-chairs are participating in the organizational meeting for the Local Advisory Council for Mental Health.

g) Health Care Planning Committee - Ginny Storlie (Primary), David Mills (Alternate)

Storlie reported that she was not able to attend, but she shared that Rita Plourde is looking into retirement. The Clinic Board is now working on finding a replacement. Plourde will be missed, and difficult to replace.

h) North Shore Collaborative - Jan Sivertson (Primary), Heidi Doo-Kirk (Alternate)

Mills reported that the biggest part of the meeting was looking over grant applications. They switched to a quarterly process.

i) Emergency Preparedness Committee - Ginny Storlie, Myron Bursheim

Did not meet. j) Board Comments for the Good of the Order - All

Commissioner Deschampe shared that he had attended Sovereignty Day at the capital and had carried the flag for the Grand Portage Band. He added that the chairman from each tribe spoke to the group. Also discussed was sovereignty and government relations. There was a Q and A period where representatives asked a lot of questions. He also discussed Lt. Governor Flannigan’s statement that native communities are often invisible to policymakers.

Commissioner Doo-Kirk shared that previously she had attended an Opioid Committee meeting. She shared that SF 751 and HF 400 are on the legislative docket. What is being discussed is a fee or surcharge or opioid manufacturers. The funding would come to counties on a per-case basis and not based on population. She added that drawing attention to drug addiction and opioids was important to Norman Deschampe.

Commissioner Bursheim shared that the Cook County YMCA Advisory Council had met the night before. He shared that the YMCA looks at the needs of the

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https://youtu.be/wUViZIsqqAM

https://www.revisor.mn.gov/bills/bill.php?b=senate&f=SF751&ssn=0&y=2019

https://www.revisor.mn.gov/bills/bill.php?b=House&f=HF400&ssn=0&y=2019

community. He added that the YMCA looks at childcare and childcare programs. There is a room at the YMCA for children to stay in before and after school if needed. He shard that the room was used a lot on the days school was closed, and there were also a lot of children using the gym and pool. He added that the YMCA does not close due to bad weather and is always open for a place to go.

Commissioner Storlie shared that last week she had attended the health committee meetings. There was a presentation by Hennepin and Ramsey county surrounding arrest and incarceration and mental health. It was interesting to hear the statistics and figures. Another program that the state is hoping to start is Families First.

Commissioner Mills discussed a session he attended at the AMC conference on Competency Restoration. He shared that he had attended a meeting and it was very intense and felt more like a debate. He added that it is a very complicated and overwhelming topic.

Jerry Lilja discussed the North Shore Health Care Foundation and opportunities for funding in the year ahead. He stated that there are three key issue areas that the Foundation is focusing on, which are: services for elderly, children’s mental health and substance abuse, and medical transportation out of the county. He shared the first step is to involve what is already being done in these areas. There is a fixed contract in which funding was given to Emergency Services, Cook County Higher Ed, and Care Partners for work they are already doing.

McIntyre replied that she is familiar with the Families First initiative. This Federal law will help reform the child welfare system. DHS is working with Counties and Tribes on what the program will look like in Minnesota. She added that Competency Restoration has been discussed with by our department as well, along with the County Attorney. This was a very sudden change at the end of the year, and the department is learning more. McIntyre thanked the YMCA for opening their doors during the extreme cold weather. It was great working with the staff to establish the possible opening of an emergency shelter. She also stated that she is looking forward to looking more into the opioid bills, and how we can work together for our community. She added that she is looking forward to hearing more about Sovereignty Day and learning more on how we can improve work with Tribal Nations.

8 ADJOURNMENT a)

Motion made by Commissioner Storlie. Meeting adjourned at 9:43 am.

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COOK COUNTYPUBLICHEALTH& HUMANSERVICES

FINANCIALREPORT - Year to Date through 2/28/2019

INCOME MAINTENANCE - EXPENDITURESpreliminary

2018 2018 % of 2019 2019 YTD % ofBUDGET EXPENSE budget BUDGET EXPENSE budget

IM PROGRAM ELIGIBILITYSTAFF

Salaries & Fringe 460,824 396,738 465,498 34,915Travel Expense 9,000 7,583 10,000 588

Misc. expenses/supplies 750 442 2,079 56

EDMS 7,482 14,792 16,812 3,118Administrative Allocation 191,324 179,065 189,574 15,566

669,380 598,619 89% 683,963 54,243 8%PUBLICASSISTANCE

County Paid Burials 5,000 3,200 5,000 —

Co. Share Nursing Home <65 7,929 11,659 9,884 l—~

Estate Recovery Costs - 13 3,000 13

Health Care Access 38,380 25,593 40,300 1,478Provider HCTransportation 16,000 10,389 16,000 443

Reimbursed Insurances 45,000 56,550 45,000 12,272100% County - HCAccess 750 250 250 —

113,059 107,654 95% 119,434 14,206 12%FOOD SUPPORT

Enhanced Funding 545 — 545 —

CHILDSUPPORT

Contracted Services 133,000 133,000 133,000 —

Legal Fees 3,850 3,695 3,850 —

Service of Process 700 — 700 —

Miscellaneous 50 — 50 —

Paternity Establishment — - - -

Federal Tax Intercept Offset 300 268 300 —

EDMS 6,298 2,298 3,000 —

144,198 139,261 97% 140,900 — 0%

TOTAL IM EXPENDITURES 927,181 845,534 91% 944,842 68,450 7%

3/13/2019 Monthly Report 2019 #2 February Page 2

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INCOME MAINTENANCEREVENUE

IM ADMINISTRATIVEREVENUE

Federal Administrative AidMA Incentive State/FederalPeriodic Data Match

RECOVERIES

IM Program Recoveries

Less: Recoveries paid to DHS

PUBLICASSISTANCE

County BurialHealth Care Access

Provider Transp Health PlanReimbursed Insurances

FOOD SUPPORT

Food Support Enhancement

CHILDSUPPORT

‘Federal Administrative AidFederal IVDIncentive

State IVDIncentive

Fees/RecoveriesOther

OTHER

Misc. Recovery

County Tax

Use of Fund Balance

TOTAL IM REVENUE

3/13/2019

2018BUDGET

292,499

5,592

3,249

301,340

15,850

15,850

38,3808,480

45,000

91,860

545

95,171

8,652

1,298200

105,320

412,266

412,266

927,181

preliminary2018 %of

REVENUE budget

273,835

3,499

2,552

279,885

9,589(76,582)

(66,993)

26,558

54,443

81,001

77,665

16,693675

75

95,108

32

360,378

360,410

749,412

93%

—423%

88%

90%

87%

81%

Monthly Report 2019 #2 February

2019BUDGET

310,5236,046

2,552

319,121

32,860(24,384)

8,476

40,300

8,480

45,00093,780

545

92,994

8,454

1,268200

102,916

420,004

420,004

944,842

2019 YTDREVENUE

9,400

9,400

41,084

41,084

169

3,9724,141

58,925

%ofbudget

3%

485%

4%

4%

0%

6%

Page 3

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SOCIALSERVICESEXPENDITURESpreliminary

2018 2018 % ofBUDGET EXPENSE budget

DIRECTSERVICESTAFF COSTS

Salaries & Fringe 1,197,425 853,413Case Management Travel 39,702 28,874Travel/Training 24,039 16,820Licensing/Dues — -

Contracted Services — -

Miscellaneous 17,805 6,237Program Materials/Supplies 1,939 684

SSISComputer Cost/Travel 5,964 2,112AMHI Admin Expenses 500 2,855In-Home Support Admin Expenses 12,648 13,582Advance gas/phone cards - (200)

Administrative Allocation 402,577 567,6221,702,600 1,491,999 88%

CHILDRENSSERVICES

Alternatives to Placement 29,916 22,545Family Response 3,788 20,103Parent Support Outreach 12,785 8,754Family Planning/ NS Collaborative 1,300 500

Adolescent LifeSkills(SELF) 1,000 -

Licensing Expense 1,000 1,233

49,789 53,135 107%

OUT OF HOME PLACEMENTS

Kinship Care — 2,392

Shelter Care 21,516 —

North Star Care:

Family Foster Care 143,188 86,972

Treatment Foster Care 48,141 29,645

Rule 8 Group Home 48,810 57,540

Correctional Placement 30,043 -

Child Placements - Rule5 195,862 44,934487,560 221,484 45%

CHILDCAREEMPLOYMENT& TRAINING

County Share Basic Sliding Fee 392 392

Other ChildCare 5,450 5

Employment & Training 21,500 21,500Supported Work — —

Training & Transportation - —

Licensing Expense 2,000 —

29,342 21,897 75%

3/13/2019 Monthly Report 2019 #2 February

2019BUDGET

1,181,977

39,702

28,000

7,907

2,200

5,964500

16,170

402,844

1,685,264

29,916

3,935

12,814500

2,0001,000

50,165

12,258

214,872

94,502

195,882

517,513

392

21,500

1,000

22,892

2019 YTDEXPENSE

84,198

1,377

2,092

565

62

5,405

2,000

51,437

147,136

91

1,045220

%ofbudget

9%

1%

0%

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SOCIALSERVICESEXPENDITURES- continued

CHEMICALDEPENDENCY

Detox Transportation

Detox

Detox/Eval& HoldCCDTF- County Share‘Rule 25/ Other

2018BUDGET

200

8,232

1,000

25,869

35,301Wilderness Outpatient Treatment Program:

Contracted Services

Related Outpatient Expenses

EDMS

Administrative Allocation

MENTAL HEALTHPurchased Mental Health Services:

Human Development Center

Children's Services:

Other services, Respite

Adult Services:

72 Hour HoldCounty Share Case Mgmt

AMHI Services

DEVELOPMENTALDISABILITIES

Family Support Grant

Other DDServices

Employment Services

Waiver - Services

ADULTSERVICES

Other Adult WelfareWaiver Purchased Services

In Home Support Services

TOTAL SS EXPENDITURES

3/13/2019

75,628

1,160

2,10027,320

106,208

161,552

14,700

9,000

28,000

213,252

3,745

4,800

8,545

3,16360,714

9,264

73,141

preliminary2018

2,864

24,893

27,757

75,644

1,600

2,135

37,635

117,014

136,562

6,448

2,269

63,207

208,485

443

17,073

17,515

2,80546,28515,292

64,382

2,705,738 2,223,668

% ofEXPENSE budget

79%

110%

98%

205%

88%

82%


2019BUDGET

200

4,075

1,500

26,981

32,756

77,520

1,000

2,120

27,317

107,957

161,552

7,780

9,000

79,059

257,391

3,000

6,229

65,889

75,118

1,914

76,63815,02993,581

2,842,637

2019 YTD %ofEXPENSE budget

— 0%

12,920

2,143

15,063 14%

301

1,7972,098 1%

- 0%

431

3,4961,574

5,502 6%

176,377 6%

Page 5

of 51

SOCIALSERVICESREVENUE

ADMINISTRATIVEREVENUE

SSISComputer Federal ShareVulnerable Children & Adults Act

Social Welfare Fees

MiscellaneousLiability Insurance: In-Home Support

Misc Funding: ln—HomeSupport

BLOCKGRANTREVENUE

Title XIX

LTSSSSTS

Children & Community Services:

State BlockGrant

Federal Title XX

CHILDRENSSERVICES

Adolescent LifeSkills(SELF)Family Response

Parent Support OutreachIVEAdministrationCW-Targeted Case Management

CW—TrainingI

CADIWaiver — Case Management

Miscellaneous Recovery

OUT OF HOME PLACEMENTS

Children's Services:

North Star KinshipCare

IVE— Foster Care ReimbursementOther Recoveries

Mental Health Services:

Rule 5 - MA ReimbursementIVEReimbursementParental Fee/Insurance

CHILDCARE EMPLOYMENT& TRAINING

Child Care Administrative Earnings

Employment & Training

Training/TransportationLicensing Revenue

3/13/2019

2018BUDGET

5,500

75,000

7,512

1,200

89,212

32,039

137,105

83,195

44,601

296,940

1,000

3,788

12,785

8,03423,529

1,720

2,800

53,656

11,253

17,853

6,673

35,779

3,959

21,500

850

26,309

preliminary2018

REVENUE

2,259

72,130

9,2505,6081,058

574

90,879

38,390

207,405

83,19944,597

373,591

780

2,841

9,589

24,229

42,45189

7,436550

87,965

48,260

12,131

37,719

98,110

1,833

22,393

400

24,626

% ofbudget

102%

126%

164%

274%

94%


2019BUDGET

4,47375,000

9,576

1,200

90,249

32,039

137,105

81,848

44,205295,197

2,0003,935

12,814

3,635

31,140

1,720

1,850

57,094

11,253

8,077

2,884

22,214

4,077

21,500

850

26,427

2019 YTDREVENUE

718

325

1,043

3,6843,684

% ofbudget

1%

1%

11%

5%

0%

Page 6

of 51

SOCIALSERVICESREVENUE- continuedpreliminary

2018 2018 % of 2019 2019 YTD % ofBUDGET REVENUE budget BUDGET REVENUE budget

CHEMICALDEPENDENCY

Rule 25 Assessments SSTS 14,480 17,326 15,363 —

CCDTFAdministrative 3,900 5,220 7,300 —

Miscellaneous Recovery — 1,755 - 92

Wilderness Outpatient Treatment Program:

Liquor License Fee 15,060 15,590 14,610 -

Rule 25 Assessment-private/insurance 7,000 215 1,915 70

Service Fees-private/insurance 24,872 4,926 12,684 —

Service Fees-CCDTF 10,000 - 1,164 —

75,312 45,032 60% 53,036 162 0%

MENTALHEALTHChildren's Combined/Screening 1,340 1,340 939 —

Children's MH-TCM 41,664 33,448 49,296 2,256Children's Respite Grant 10,000 2,589 - —

Adult MH Integrated Moose Lake Fund 71,040 64,152 71,040 —

Adult MH-TCM 43,548 18,062 84,060 976

Adult AMHI Recovery/Misc — 175 - —

Adult AMHI Mini Grant — — - —

Reimbursement AMHI Position 72,000 72,000 72,000 —

239,592 191,766 80% 277,335 3,232 1%

DEVELOPMENTALDISABILITIES

Family Support Grant 3,745 443 3,000 —

Other Services — 13,194 66,889 —

Waiver Case Management 27,000 53,915

Waiver Services — 3,878 30,665 2,591

VA/DDTCM — Federal 1,386 - - —

32,131 71,431 222% 100,554 2,591 3%

ADULTSERVICES

Purchased Services 51,500 53,677 68,975 793

Case Management/Care Coordination 105,118 201,526 105,118 4,067Recoveries 4,285 2,711 3,012 -

Adult Foster Care Licensing 500 — - -

161,403 257,913 160% 177,105 4,860 3%

OTHER

County Tax Levy 1,695,404 1,585,445 1,743,427 -

Use of Fund Balance — - -

1,695,404 1,585,445 94% 1,743,427 - 0%

TOTAL SS REVENUE 2,705,738 2,826,758 104% - 2,842,637 23,096 1%


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PUBLICHEALTHEXPENDITURES

PROVIDEDSERVICES

Salaries & Fringe

Other Services & Charges:

Family PlanningCollaborative

AMC Committee WorkTravel & Training

Program Cost/SuppliesEDMS

MCH Program Expenses

Public Health Preparedness Program

Administrative Allocation

COMMUNITYHEALTHFUND

PURCHASEDSERVICES

North Shore Hospital:Home Care Sliding Fee

Sawtooth Mountain Clinic:ClinicOutreach Services

Women, Infants & ChildrenWIC - Breastfeeding Grant

Universal Home Visiting

Child & Teen CheckupSHIP Grant

TOTAL PH EXPENDITURES

3/13/2019

2018BUDGET

165,868

800

500

575

3,200

5,000

7,500

12,100

20,125

61,782

277,450

25,000

30,500

21,9943,500

6,000

38,873125,867

403,317

preliminary2018 %of

EXPENSE budget

97,165

500

2,018

1,579

6,838

2,008

21,228

57,027

188,363

25,000

30,070

25,144

3,234

5,967

37,6312,245

129,291

317,653

68%

0%

103%

79%


2019 2019 YTD % ofBUDGET EXPENSE budget

155,208 9,436

800 -

500 —

575 -

5,000 161

6,200 —

7,500 -

2,600 -

19,876 262

63,191 5,149

261,450 15,007 6%

130,000 130,017 100%

25,000 —

30,500 1,377

21,842 1,928

3,500 —

15,381 —

10,000 —

38,862 2,554145,085 5,859 4%

536,535 150,883 28%

Page 8

of 51

PUBLICHEALTH - REVENUEpreliminary

2018 2018 % of 2019 2019 YTD % ofBUDGET REVENUE budget BUDGET REVENUE budget

Provided Services Revenue

LocalPublicHealth Grant 32,727 32,727 32,724 -

Family Connect 6,000 — 11,101 -

Home Visitor Insurance/MA 2,800 7,531 3,700 —

EHDI - — — —

Follow Along 1,933 2,263 1,933 —

Fees - Immunization 2,000 1,098 2,000 —

LocalCollaborative Time Study (LCTS) 16,000 23,396 16,000 —

Child& Teen Checkup 8,567 5,687 4,520 —

Public Health Preparedness 20,125 20,419 19,876 —

Miscellaneous Recovery — 7 — —

90,152 93,128 103% 91,854 - 0%Purchased Services Revenue -

Child& Teen Checkup 6,000 7,462 10,000 -

SHIP Grant 38,873 38,380 38,862 -

WIC Grant- Federal 21,994 22,636 21,842 -

WIC - Breastfeeding Grant 3,500 3,234 3,500 —

BCBSReimb /Tobaccorevenue 1,000 — 1,000 -

71,367 71,713 100% 75,204 - 0%OTHER

County Tax Levy 241,798 225,128 369,477 —

Use of Fund Balance — — — -

241,798 225,128 93% 369,477 — 0%

TOTAL PH REVENUE 403,317 389,968 97% 536,535 —

' 0%


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ADMINISTRATIVECOSTS8: ALLOCATIONpreliminary

2018 2018 % of 2019 2019 YTD % ofBUDGET EXPENSE budget BUDGET EXPENSE budget

Salaries & Fringe 500,104 682,860 497,404 65,456Communications 16,937 13,266 16,937 607Postage 4,000 2,961 4,000 —

Photo Copies 17,000 15,839 17,000 —

Advertising/Recruiting 1,873 351 1,873 —

Administrative Dues 5,500 2,108 5,500 —

IS Dept Allocation 47,158 45,825 47,158 —

PHHS Board/Advisory Travel 2,090 1,879 2,600 —

State Auditor Fee 4,150 2,476 4,150 —

Merit System 5,388 7,388 7,276 1,875Staff Travel/Training 17,408 9,480 15,000 12Rent 41,715 41,715 41,715 —

Miscellaneous Expense 4,680 6,136 6,287 41Office Supplies 5,500 4,280 5,500 682

MN Computer Support 5,150 — 5,150 —

Liability Insurance 4,349 4,831 5,376 5,577683,002 841,395 123% 682,926 74,250 11%

ALLOCATION:

income Maintenance 191,324 179,065 189,574 15,566Social Services 402,577 567,622 402,844 51,437Wilderness Outpatient 27,320 37,635 27,317 2,143Public Health 61,782 57,027 63,191 5,149

683,002 841,350 123% 682,926 74,295 11%


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Addendum 1

ADDENDUM T0 MASTER CONTRACTwith

SAWTO OTH MOUNTAIN CLINICOctober 1, 2018- September 30, 2019

WIC, Women, Infant and Children Program

WHEREAS,the agreement Master Contract exists by and betweenCook CountyPublic Health & Human Services and Sawtooth Mountain Clinic and was entered intoon the 1“day of January 2011 and is effective inde?nitely and

WHEREAS,the County desi.resto maintain all provisionsof the Master Contractbutdesiresto add an addendumto the contract speci?cally for WIC and,

WHEREAS, Sawtooth MountainClinicwill administera WIC Program within itsdesignated service area or population in an ef?cient and effective manner and incompliancewith: the most recent editionof the MinnesotaWIC Program Operationsmanual(hereinafter MOM); MinnesotaRules Chapter 4617; 7 CFR Parts 15, 15a, 15b,246 and 3015 to 3019; Office of Management and Budget (OMB) CircularA-130; andUSDA guidelines and instructions.

Perform all of the GRANTEE’S dutiesunder this project agreement in accordancewithMOM, MinnesotaRules Chapter4617, 7 CFR Parts 246 and 3015 TO 3019; USDAguidelines and instructions,and OMB Circular A-87. This includesconducting quarterlytime studiesso that staff time charged to the W1C grant is accurate. .

Complywith the followingstatues and the regulations adoptedunderthem, to the extentthat these statues and regulations are applicable to the GRANTEE: (1) Title"\{l;of‘tl1e'_Civil Rights Act of 1964,United States Code, title 42, sections2000d to 2000d-4a’,asamended; (2) Title IX of the EducationsAmendments of 1972,United States Code,title20, sections 1681 to 1688, as amended; (3) section 504 of the RehabilitationActof 1973,United States Codes, title 29, section 794, as amended; (4) The Age Discriinin'ation‘Actof 1975,United States Code, title 42, Sections 6101 to 6107, as amended; and (5) theAmericans withDisabilitiesAct of 1990,United States Code, title 42, sections12101 to12213, as amended.

Comply with the Single Audit Act of 1984, as amended (31 U.S.C. section 7501 et seq.),OMB CircularA—87,and OMB Circular A-133.

The books,records, documents,and accountingprocedures and practicesof theGRANTEE relevant to this project agreement shall be made availableto and are subjectto examinationby the STATE, including the contracting Agency/Division, LegislativeAuditor, and State Auditor for a niiniinumperiod of six years after the date of the bookrecord, document, or accounting procedure or practice.

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Incorporate any law and federal guideline, instructionand Circularsthat become effectivewhile this subcontractis in effect, includingl\/Iinnesotaand United States statutoryamendmentsand new statutes, rule amendmentsand new rules in Minnesota Rules,federal regulatory amendmentsand new federal regulations, USDA guidelines andinstructionsand OMB circulars.

WHEREAS, the speci?c project duties are de?ned and highlighted for the Provider inthe attached WIC Program Award Letter for Carlton, Cook,Lake, St. Louis CamrmmityHealth Board and,

VVHEREAS,the total expenditures to complete these duties shall not exceed $20,2 78 andinvoices are due to Public Health and Human Services monthly, on or before the 5”‘day of each month:While MDH anticipates continued funding, if Minnesota's actualfederal fundingaward changes from what has been anticipated, the authorizedcaseloadand administrativefunding levels may need to be adjusted accordingly.

WHEREAS, changes to any allocationsas describedabove will require a written request?om the Providerwhich includesthe amount of the expenditure and the justification forthe change and approval and agreement from the County now therefore,

IT IS AGREED BY AND BETWEEN THE PARTIES THAT saidMaster Contract isamended for theperiod of October 1, 2018- September30, 2019 for the purposes of theWIC program, effective upon signature.

PROVIDER COUNTY:Cook County Public Health &Human Services Director

M45/«——-——\AQMHgliga?. -

S wtoo Mountain Clinic Director

Date Date

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Addendum 2

An Amendment to the:ADDENDUM TO MASTER CONTRACT

withSAWTOOTH MOUNTAIN CLINICOctober 1, 2018 — September 30,2019

WIC Peer Breastfeeding Support Program

WHEREAS, the agreement Master Contract exists by and betweenCook CountyPublic Health & Human Services and Sawtooth Mountain Clinic and was entered intoon the 1“day of January 2011 and is effective inde?nitely and

WHEREAS, the County desires to maintain allprovisions of the Master Contract butdesires to add an addendumto the contract speci?cally for WIC Peer BreastfeedingSupport Program and,

WHEREAS, the speci?c projeet duties and responsibilities for reporting and evaluationare defined and highlighted for the Provider in the Work Plan for Carlton, Cook, Lake, St.Louis CommunityHealth Board and,

WHEREAS, the total expenditures to completethese dutiesshall not exceed $3500 andmust be spent as shown in the chart below and ?nancial reports will be submittedtoPublic Health and Human Services on a quarterly invoice. Due dates are: January 5,2019, April 6, 2019, July 6, 2019, and October 5, 2019.

Salaries $3,500Total Amount $3,500

VVI-IEREAS,changes to any allocations as describedabove will require a written requestfrom the Provider which includes the amount of the expenditure and the justi?cation forthe change and approval and agreement from the ‘Countynow therefore,

IT IS AGREED BY AND BETWEEN THE PARTIES THAT said Master Contract isamended for the period of October 1, 2018- September 30, 2019 for the purposes of WICPeer Breastfeeding Support Program, effective upon signature.

COUNTY:Cook County Public Health &Human Services Director

%Hcim.l-TxrSay00 Mountain Clinic Director

7/t§"(20g2Date Date

PROVIDER

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Addendum 3

ADDENDUMT0 MASTER CONTRACTWith

SAWTOOTH MOUNTAIN CLINICNovember 1, 2018 —0etober 31, 2019

SI-HP4.0 Year 4

WHEREAS, the agreement Master Contract exists by and betweenCook CountyPublic Health & Human Services and Sawtooth Mountain Clinic and was entered intoon the 1“day of January 2011 and is effective inde?nitely and

WHEREAS, the County desiresto maintainall provisions of the MasterContract butdesiresto add an addendumto the contract speci?cally for SHIP 4.0 and,

WHEREAS, the speci?c project duties and responsibilities for reporting and evaluationare de?ned and highlightedfor the Provider in the SHIP 4.0 Year 4 Work Plan forCarlton, Cook,Lake, St. Louis CommunityHealth Board, SMC Contract Coversheez‘,and,

WHEREAS, the total expenditures to completethese dutiesshall not exceed $38,638 pergrant year andmust be spent as shown in the chartbelow and

SHIP 4 Year 4:Salaries $32,574Travel $1,807Supplies $1,000Other -

Admin -

Indirect Costs $3,257Total Amount $32,638

WHEREAS, changesto any allocationsas describedabove will require a written requestfrom the Providerwhich includesthe amount of the expenditureand the justification forthe change and approval and agreement from the County now therefore,

IT IS AGREED BY AND BETWEEN THE PARTIES THAT said Master Contract isamendedfor the period of November1,2018 -— October31, 2019 for the puiposes ofSHIP 4.0 Year 4 effective upon signature.PROVIDER COUNTY:

Cook County PublicHealth &. I-Iu Services Director

We H V.

S' wtoothMo tain Clinic Director

gm [M/7Date Date

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Addendum 4

ADDENDUM TO MASTER CONTRACTwith

SAWTOOTH MOUNTAIN CLINICJanuary 1, 2019 — December 31, 2019

Child and Teen Checkup

WHEREAS, the agreement Master Contract exists by and between Cook CountyPublic Health & Human Services and Sawtooth Mountain Clinic and was entered intoon the 15“day of January 2011 and is effective inde?nitely and

WHEREAS, the County desires to maintain all provisions of the Master Contract butdesires to add an addendumto the contract speci?cally for Child andTeen Checkup and,

WHEREAS, the speci?c project duties and responsibilities for reporting, and evaluationare defined and highlighted for the Provider in the Work P1an_forCarlton, Cook:Lake, S2‘.Louis C0mmz4m'tyHealth Board Subcontract form for DHS and Script Language forLetters and Voice messages and,

WHEREAS, the total expendituresto complete these duties shallnot exceed $10,000.00and shallbe submitted on the attached invoice to Public Health and Human Servicesonthe following:April 6, 2019, July 6, 2019, October 5, 2019 and December 26, 2019.

WHEREAS, changes to any allocations as describedabove will require a wiitten requestfrom the Provider which includesthe amount of the expenditureand the justi?cation forthe change and approval and agreement from the County now therefore,

IT IS AGREED BY AND BETVVEENTHE PARTIES THAT said Master Contractand the Addendum to the Master Contract with final signature is amendedpursuant tothe above terms for the period of January 1, 2019 - December 31, 2019 for the purposesof Child and Teen Checkup Program, effective upon signature.

VIDER COUNTY:Cook County Public Health &Human Services Director

ML/«m__ Q 1l 9 W

awtoo '1Mountain Clinic Director

?g ’.5[2d/9'D '

‘ Dateate

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Attachment #1

Script for Cook County/Sawtooth Mountain Clinic

lNTRODUCTlON LETTERPhone Calls

Hi, this is and I am calling about the letter you received about Childand TeenCheckups (C&TC). Childand Teen Checkups health checks are covered by Medical Assistanceand your health plan, so there is no cost to you. You may alsobe eligiblefor incentives to keep

current on theirexams.your child

Childand Teen Checkups health visits are done by your own cloctoratyour clinic. Do you have a

Dr. that you usually bring your childto? (ask about immunizations being current)

If no: ’’Itis important to have a regular medicalclinicso you getto knowclinicstaffand they

get to knowyou and your child.” Callthe CookCounty/Sawtooth lvlountain Childand TeenCheckups program number on the brochure and you willgetpersonalizedhelp in?nding a

clinic.”

If yes: ’’Itlooks like you do a great job getting (child's name) to the doctor. Be sure to askfora

Child and Teen Checkup when you make your appointment. Callyour health plan to findout

what incentives they have to offerfor regular preventative visits.”

Emphasize reasons why preventive health care screenings are important to a children, teensand young adults:

- Childand Teen Checkups health checks help keep children,teensand young adultshealthy.

0 Children,teens and young adults who have regular checkups tend to ha_vefewerhealthproblems.

0 A child's health and dental problems can befoundand treated early. Early treatmentcan reduce the impact ofhealth problems. , . . .

- Childrencan get tested for anemia, exposure to lead or tuberculosis and other diseases.0 Parents, teens and young adults can get informationabout healthy lifestyles.- Healthy children are more ready to learn.0 Teens and young adults can learn to take charge of_theirown health, with family

support.

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Remind parent when next checkups are due for children, teens and young adults.

2 weeks 2 months 4 months 6 months 9 months

12 months 15 months 18 months 24 months 30 months

3 years 4 years 5 years 6 years 7 years

8 years 9 years 10 years llyears 12 years

13 years 14 years 15 years 16 years 17 years

18 years 19 years 20 years

Highlight what is included in a Child and Teen checkups health check:

* Complete head to toe physical exam

* Checks on development and growth

* Hearing & Vision checks

* Immunization review

* Referral to the dentist

* Fluoridevarnish treatment

* Information about good physical and mental health

* Time to ask questions and get answers about your child's health, behavior anddevelopment

* Time to discuss thoughts, feelings and relationships

Most health plans offer incentives, like gift cards, for bringing your child in for their Child andTeen checkup”,

0 When you schedule your child's appointment, make sure to schedule it as a Child andTeen Checkup to receive these benefits. These also work great for sports, camp or

school physicals as they are a thorough exam of your child's health.

of 51

Here is what the Cook County/Sawtooth Mountain Child and Teen checkups program staffcan do to help you and your family:

Fina’a clinicor dentistSchedule appointmentsArrange transportation

Arrange for an interpreterSend reminders when appointments are dueConnect you to specialists

ifyou have any questions, need assistance in scheduling or transportation to the appointment,please call me at: . (be aware also of any translator needs).

REMINDERLETTERPhone Calls

Hi, this is , and Iam callingabout the reminder letter you received about(child’s name) '5 (child's age) Childand Teen checkup. Have you had a chance to get

him/herin yet for that exam?

o Ifno: is there anything I can help you with in scheduling that appointment with (child's

Ifyes: ”Great. Do you schedule their exam as a Childand Teen Checkup?”o if yes - ”Wonderfuli Lookslikeyou're doing a great job — is there anything else

we can help you with today?0 If no — ”AChildand Teen Checkup is a more thorough exam than a regular well-

child or teen health visit. You willhave more time with the doctor to askquestions. The Dr is able to keep closer tabs on growth and development, andmonitor for hearing and vision changes. Most health plans offer incentives, likegift cards, for bringing your child in for their Childand Teen checkup. These alsowork great for sports, camp or school physicals as they are a thorough exam ofyour child's health.”

name "5doctor? Ifyou need assistance in scheduling or transportation to theappointment, please call me at: . (be aware also of any translator needs).

of 51

Appendix C2019

2018-2020 C&TC Administrative ServicesSubcontracting/Constilting Costs Information Form

. Please describethe proposed C&TC outreachproject.

Cook County PublicHealth and Human Services will continueour contract relationshipwith Sawtooth Mountain Clinic. Our agreement is for the clinic to follow the 5 objectivesof the 2019 Carlton Cook Lake St. Louis C&TC AdministrativeserviceWork Planutilizing the methods listed in the work plan to completethe required activities

What is the name of the subcontractorwho will be providingthe outreachservices?Sawtooth Mountain ClinicFederally funded Community Health Clinic, 501C3

Will there be eithera formal contract or agreement with the subcontractorproviding theoutreach services? Do they have a choiceabout a contract/agreement? ’

There is a formal master green contract betweenCook County PublicHealth and HumanServicesand Sawtooth Mountain Clinic. Child and Teen Checkup is one component ofthe annual addendumto the master contract. The agreement is mutually accepted by bothparties

. How will the staff providing the outreach be supervisedor monitored to ensure thatrequirements of contract/agreement are met? Who will have responsibilityforsupervision/monitoring?

The ExecutiveDirectorof Sawtooth Mountain Clinic will provide directsupervision ofstaff providing Child and Teen Checkup outreach. SawtoothMountain Clinic staff entersdata into CATCH and implements and monitors all outreach activities. ’

The Cook County Public Health Coordinator will arrange and conductquarterlymeetingsto review the contract requirements and provide regional updates for the SawtoothMountain clinicnurse. Phone communicationand email exchange occurs betweenquarterly meetings to review changes and discussupdates.

. Please attach the script outline that will be used to communicateC&TC messages.Identify the speci?c activities that will be performed.

Attachment #1-

. How much time will be spent providing C&TC outreach per family contact?I

Time spent providing C&TC outreach per family is approximately 20-30 minutes.Page 1 of 3

of 51

7. What is the proposed annual budget amount of the C&TC outreach services that will be

10.

provided‘?

$10,000:

Teresa BoralcRN,FTB: .065# hrs. anually: 135.5Wage: $28Fringe: $7.84

Carin GulstrandFTE: .05#h.rs.anually: 99.5Wage: $17Fringe: $4.76

Training:C&TC trainingSawtooth MountainClinic nurseTime: 18hrs. = $645.12Miles: $272.50

Lodging: $180.Meals: $50.Total: 1147.62

Office space: $1440.

Printing: $250

What is the cost per each outreach activity?$18.00

How was the amount per outreach activity calculated?The outreachannualbudget amount is $10,000Sawtooth Mountain Clinic estimated 553 contacts to equal $18.08Rounded to the nearest dollar = $18.00 per outreach

Please describehow the results of the C&TC outreach will be evaluated.

Cook County Public Health Coordinator meets with Sawtooth Mountain clinic nursequarterly to review the C&TC contract, work plan, budget and outreach initiatives andwill discussany necessary changes for effective C&TC outreachBudget is reviewed and monitored by county ?nancial supervisor with quarterlyinvoices.

Page 2 of 3

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ll.

12.

Together Cook County public health and Sawtooth clinicstaff collatethe narrative resultsfor the annualCarlton Cook Lake St. Louis Co. C&TC narrative report and alsoinformation as required by DHS for annual reporting.

Does this subcontrac-toralready provide this service as part of their work? (Forexample,home visiting nurses typically discuss preventive care and programs availablewithclientsas a part of their visit).

YesCook County Public Health and Human Services have a Master Contract with SawtoothMountain Clinic.This contract addendum is speci?c to Child and Teen Checkup.

Does this subcontractorprovide the same or similar educationoutreachor servicefor allpeople whether or not they are enrolled in MedicalAssistance?

Yes, Sawtooth Mountain Clinic provides a range of services.The details of C&TC follow the 5 objectives and are speci?c to the MA plan participants‘

Page 3 of3

of 51

Addendum 5

ADDENDUM T0 MASTER CONTRACTwith

SAWTO OTH MOUNTAIN CLINICJ:mua1'y1,2019 — December 31,2019

Outreach Services

WHEREAS, the agreement Master Contract exists by and between Cook CountyPublic Health & Human Services and Sawtooth Mountain Clinic and was entered intoon the 15‘day of January 201 l and is effective inde?nitely and

WHEREAS, the County desires to maintainall provisions of the Master Contract butdesires to add an addendumto the contract speci?cally for Outreach Services and,

WHEREAS, the speci?c projects and responsibilities for reporting are identi?ed inExhibit A‘ and due to PublicHealth and Human Services on the 10”‘day of each monthfollowing the month of service provision and,

WHEREAS, the total expenditures to complete these duties shall not exceed $30,500and,

WHEREAS, changes to any allocationsas describedabove will require a written requestfrom the Provider which includesthe amount of the expenditure and thejustification forthe change and approval and agreement from the County now therefore,

IT 'IS AGREED BY AND BETVVEENTHE PARTIES THAT said Master Contract isamendedfor the period of January 1,2019- December31, 2019 for the purposes ofOutreach Services,effective upon signature.

COUNTY:Cook County Public Health &Human Services Director

Tirector

PROVIDER

Sa tootl Mountain Clinic

77’7 29/ 6Date Date

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Addendum 6

ADDENDUM TO MASTER CONTRACTwith

SAWTOOTH MOUNTAIN CLINICOctober 1, 2018 — December 31, 2019

Universal Family Home Visiting Program

WHEREAS, the agreement Master Contract exists by and betweenCook CountyPublic Health & Human Services and Sawtooth Mountain Clinic and was entered intoon the 15‘day of January 2011 and is effective inde?nitely and

WHEREAS, the County desires to maintain all provisions of the Master Contract butdesires to add an addendumto the contract speci?cally for UniversalFamily HomeVisiting and,

WHEREAS, Universal Family Home Visiting is de?ned as a voluntary, home-basedservice offered to all Cook County families regardless of income or status that providessocial, emotional,health—relatedand parenting support and information to families,andlinks them to appropriate resources.

WHEREAS, the provider will bill third party payers according to establishedbillingpractices for third party reimbursement.Services are to be providedfree of charge topersons who are not eligible for third party reimbursement.

WHEREAS, the responsibilitiesfor reporting are de?ned for the Provider in Exhibit ASawtooth MountainClinic - FamilyHome Visiting Invoice and Reporting,and are due toPublic Healthand Human Services on the 10"‘day of each month following the monthofserviceprovision and,

VVHEREAS,the total expendituresfor this agreement shall not exceed$61,613 and shallbe submittedon the attachedExhibit A SawtoothMountainClinic - Family HomeVisiting Invoice and Reporting to Public Health and Human Servicesby the l5‘“of thefollowing month. '

WHEREAS, changes to any allocationsas describedabove will require a written requestfrom the Provider which includesthe amount of the expenditureand the justification forthe change and approval and agreementfrom the County now therefore,

IT IS AGREED BY AND BETWEEN THE PARTIES THAT said Master Contract isamendedfor the period of October 1, 2018 — December31, 2019 for the purposes ofUniversal Family Home Visiting Program, effective upon signature.

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PROVIDERSawtooth Mountain Clinic

R" a Plourde, CEO

55/9[Lo/9Date

COUNTY:Cook County Public Health &Hu an Services

Alison McIntyre, Direct r

Date

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Exhibit Ato the Addendum to the Master Contract with Sawtooth Mountain Clinicfor UniversalFamilyHome VisitingServ

Sawtooth Mountain Clinic — Family Home Visiting Invoice and ReportingSend to Cook County PHHS by 15th of following month Expenses for month of: SAMPLE

DirectServices:(time with mom/baby/child)

Number of Hannah Teresa Sherriclients seen

0 Prenatal 2 1 ## ## ## 27.50

0 Postpartum 1 3 ## ## ## 82.50

0 Baby/Children 3 3.5 ## #1: #11 233.75

343.75

N

rvicyeszy(all time exceptlwithycliejritsrf"

Hannah Teresa Sherri

0 Calls, Charting, Nightingale

Notes/FHVRS,Meetings, Travel 1.5 ## 13 ## ## 398.75

oTralning 3 #3: #41 11 ## 385.00

783.75

I Supplies/Printing/Equipment

Description:

I Training (staff name, event, date, location, lodging)T

Description:

9 Mileage Miles:

0 Indirect/Admin15% on Labor/Fringe 169.13T

SMC expenses: S 1,296.63(LESSinsurance reimbursement for

FHVservicces received during

report month)*: 120.00*It is understood that insurance reimbursementsreceived for services rendered may not bereceived by the 15th of the following month.

—.

e. Due from PHHS S 1,175.53

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4Sawtooth Mountain Clinic

Together Through Life:1 5o'lF;i(J) rxutvlor pmlli 6tg.*u\.'Z.1!lI)n

Annual Expenses ]

Visiting Nurse Labor- based on in home visits S 21,420 J

Nurse Laborfor reporting requirements & quarterly meetings(3 hrs per week plus 4 quarterly trips to Duluth) 5 6,768Support Staff Labor 5 4,160Fringe Costs $ 9,05710% Indirect on Labor/Fringe $ 4,141Travel Costs for visits $ 1,145Training Stipend for new RN: S 1,000 l

Misc. Program Supplies 5 1,000 i

Total Annual Expenses $ 48,690 l

dOne Time Set Up Costs ILaptop and cell phone $ 2,250 ,-Visiting Nurse Set Up Labor (2hrs per week for 26 weeks, 1hr ’

per month for 6 months) 5 2,088Fringe Costs Set Up $ 585

EHRSet up costs $ 4,000Training Costs for 2 people (labor, travel, lodging, etc.) S 4,000Total Set Up Costs $ 12,923

1/19/2019 O.:\FinancialOffice\CFO\Grants\MiscGrants\Family Home Visits.x|sx

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COOK COUNTY COURTHOUSE

411 W 2ND STREET GRAND MARAIS, MN 55604

PH: 218.387.3620 FAX: 218.387.3020

TOLL FREE: 1.800.663.6771WWW.CO.COOK.MN.US

“…supporting the health, safety, and well‐being of our community.” www.cookcountyphhs.org

This institution is an equal opportunity provider.

Cook County Public Health & Human Services (PHHS)

Procedure to Request County Assistance for Burial

1. Spouse, child, other relative or interested friend of the decedent complete Request and Agreement for Burial Funds form prior to making arrangements for burial. Costs must be within our burial allowance and Funeral Director informed that assistance for burial costs is being requested of Public Health and Human Services.

2. Return completed application to Cook County Public Health and Human Services, Courthouse

2nd Floor, 411 West 2nd Street, Grand Marais, MN 55604. Make sure application is signed and dated.

3. A financial worker will determine the eligibility for assistance. 4. Requestor will receive Notice to Family of County Burial Determination form from a financial

worker, which will explain the approval/denial of the request.

5. A financial worker will submit a voucher for funeral home payment if request is approved and

include a copy of the approval notice to the PHHS accounting department.

6. Payment for the amount approved by the county will be made directly to the funeral home by accounting department.

7. The funeral home is responsible to collect payment for any additional expenses not approved by the county.

For more information: Cook County Public Health & Human Services (218) 387-3620

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PH: 218.387.3620 FAX: 218.387.3020



This institution is an equal opportunity provider. pg. 1

Cook County Public Health & Human Services (PHHS)

Funeral and Burial Policy Approved by PHHS Board on_______________

I. Purpose

In accordance with Minnesota Statute §261.035, Cook County will provide for the immediate disposition of direct cremation of a deceased resident of Cook County who is otherwise unable to pay the cost of disposition of their remains.

II. Authority This policy is based on the following authority: MN Statute §261.035 Cremation, Burial, and Funerals at Expense of County MN Statute §261.04 Liability of Estate MN Statute §256.935 Funeral Expenses, Payment by County Agency MN Statute §524.3-805 Classification of Claims MN Statute §390.21 Disposition; Burial III. Applications & Prior Authorization

Applications for a county burial can be made by a relative or friend of the decedent or a funeral home director.

Applications must be made prior to the funeral arrangement agreement being completed (unless weekends, holidays, or extraordinary circumstances prevent a timely application). Applications must be made the first working day after the weekend or holiday.

Application must be made to Cook County Public Health & Human Services, 411 W 2nd Street, Grand Marais, MN 55604. Cook County will determine eligibility and method of final disposition pursuant to MN Statute §261.035.

IV. Residency To be eligible for a county burial, the deceased must be a resident of Cook County:

If the decedent was open on a public assistance case, Cook County must be the county of financial responsibility (CFR).

If the decedent was not open on a public assistance case, the decedent must have a last known address in Cook County based on verification (i.e. lease agreement, rent received, utility bill, etc.).

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PH: 218.387.3620 FAX: 218.387.3020




V. Benefit Determination No payment shall be made for the funeral of any recipient who has resources sufficient to provide a reasonable funeral or where relatives are willing to pay for the funeral.

1. Available Assets

Resources owned by the deceased or responsible relative at the time of death, or within 30 days prior to death, are considered available to help defray the burial costs. “Responsible relative” is defined as the surviving spouse or parent(s) of a minor child. Cook County requires verification of all resources owned by the decedent and the decedent’s responsible relative, as of the date of death or within 30 days prior to, in order to make a determination of eligibility.

Resources include pre-paid burial arrangements, bank accounts, life insurance, trust accounts, vehicles, real estate, death benefits to which the deceased and/or responsible relative are entitled (includes veteran’s benefits, Social Security Death Benefit, joint bank accounts, nursing home trust fund, and/or social welfare fund). The responsible relative must apply for any and all available death benefits.

Any crowdfunding sources such as benefits, fundraisers, or online sources such as GoFundMe

accounts, solicited to pay for burial expenses will be considered an available asset to offset the disposition costs. Any crowdfunding benefits raised to help pay for medical expenses of a deceased recipient of Medical Assistance will be considered available if the Medical Assistance Program covered all medical expenses. Any outstanding medical bills of the deceased that are not covered by Medical Assistance may be paid by a crowdfunding source as allowable expense, however, any remaining balance in the crowdfunding source will be considered an available asset to help offset the disposition costs. And funds being raised via crowdfunding, benefits, or fundraisers may be subject to recovery for reimbursement of the county paid burial costs.

2. Excluded Assets Exclude from assets of responsible relative:

One home One vehicle, and Up to $1,000 (exclude up to $1,000 if there is a surviving spouse or parent(s) of a minor

child(ren)) 3. Property Evaluation In situations where the deceased person does not have adequate liquid assets for burial

purposes but does own real property, a county burial will not be approved. It will be the responsibility of the funeral home director to submit a claim against the deceased person’s estate, inasmuch as reasonable funeral expenses are a priority claim pursuant to MN Statute §524.3-805 (a) (2).

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PH: 218.387.3620 FAX: 218.387.3020




VI. Authorized Services If eligible for a county burial, final disposition will be by cremation. Burial of the body shall be

the final disposition only if cremation is not in accordance with the decedent’s personal preferences, the known practices of the decedent’s faith, the personal preferences of the decedent’s spouse or next of kin, or the medical examiner/coroner’s requirement for burial pursuant to MN Statute §390.21.

Immediate cremation and burial includes professional services, crematory charge and

alternative container. It also contains the casket for immediate burial. Immediate cremation and burial means there is no embalming.

Traditional funeral with earth burial or cremation includes professional services, casket,

transportation within the service area, embalming required or requested, facilities, cremation fee and alternative container and visitation one hour prior to services. The cost of body preparation done by another funeral home prior to delivery to a Cook County mortuary shall be deducted from the $2,500 basic fee. This fee covers traditional, memorial, and/or graveside services.

VII. Unauthorized Services The cost of the burial cannot exceed the county burial limits and Cook County does not permit

enhancements to the standard county burial services. If any unauthorized enhancements are made, the county may not pay for any of the burial costs. However, memorial money collected, not to exceed $100, can be used for clergy, flowers, luncheon, grave marker and other miscellaneous items not part of the county burial package.

If any unauthorized services are provided by the funeral home, the funeral home shall not be

reimbursed by the County for the unauthorized services. County payment must be accepted by the funeral home as payment in full for authorized services provided.

VIII. Maximum Burial Rates

Burial rates are determined by Cook County and are not to exceed charges as defined below and shall not exceed actual costs.

1. Immediate Cremation/Burial (No Service) - $1,800

Includes the crematory charge and alternative container. It also contains the casket for immediate burial. This option does not include a funeral service. (Immediate cremation and burial means no embalming.)

2. Immediate Cremation/Burial with Service - $2,100 Includes the same as listed above but with a funeral service. 3. Traditional Funeral with Earth Burial or Cremation - $2,500

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PH: 218.387.3620 FAX: 218.387.3020




Includes professional services, casket, transportation within the service area, embalming required or requested, facilities, cremation fee and alternative container and visitation one hour prior to services. The cost of body preparation done by another funeral home prior to delivery to a Cook County mortuary shall be deducted from the $2,500 basic fee. This fee covers traditional, memorial, and/or graveside services.

Other Costs: Grave lot maximum $150 Opening/closing of grave maximum $1,000

IX. Claims Against the Estate

In accordance with MN Statute §261.04, Cook County is permitted to file a claim against the estate of a deceased person who received a county funded burial in order to recover county costs.

X. Determination Upon receipt of all documentation, Cook County will make a determination of denial or

approval and authorization of the county burial application. Notification of the determination shall be in triplicate; one copy goes to the funeral home, one copy goes to the applicant and one copy is for the case file.

XI. Appeal Rights

If an application is denied and applicant wishes to appeal, the applicant must file with the Director of Cook County Public Health & Human services, the “County Burial, Request for Appeal” form, along with a copy of the application. The Director of Cook County Public Health & Human Services will make a final determination.

XII. Payment of County Burial

Upon receipt of all required documentation and approval, payment will be made to the appropriate vendor(s).

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Cook County Public Health & Human Services Request and Agreement for Burial Funds

Note: Burial Request must be received by county and approved prior to planning of service, funeral, or burial of deceased or the Request will automatically be denied.

Asset and Income Information Include assets and income for deceased, surviving spouse, and parents of minor

children. Verification is required.Does the deceased have a burial lot? YES or NO

If YES, cemetery name:

Within 30 days prior to death, did the deceased or a responsible relative transfer, gift, or dispose of any assets or income? YES or NO

If YES: Amount: __________________________ Date: ____________________________ Recipient: ________________________

Person completing application Name:

Relationship to decedent:

Street Address (Street, City, State, Zip):

Mailing Address (Street, City, State, Zip) if different from above:

Phone Number: Home ________________________ Work ______________________ Other ____________________

Information about the deceased Name: Date of Birth:

Social Security Number: Marital Status:

Last Street Address (Street, City, State, Zip):

Date of Death: Name(s) of surviving spouse/parents (if applicable):

Was the decedent a US Veteran? YES or NO

Is the surviving spouse or parent a US Veteran? YES or NO

Was the decedent an enrolled tribal member? YES or NO

Is the surviving spouse or parent an enrolled tribal member? YES or NO

Funeral Home/Mortuary Name: Funeral Home/Mortuary Address and Phone Number:

Agency Use Only Is Cook County Representative Payee? YES or NO

Current Status of Case: OPEN CLOSED NEVER OPENED PENDING

Case # and Programs: Agency Worker:

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How much would you or any family member of the deceased be able to contribute toward burial expenses? $_______________________________

Assets Does the deceased or responsible relative have any of the following assets? YES NO

Place of Resource/ Financial Institution

Value Owner(s)

Cash N/A

Savings Account

Checking Account

Certificates of Deposit

Life Insurance

Retirement Funds

Stocks/Bonds

Burial Funds

Trust Funds

Contract for Deed

Real Estate

Vehicles

Other

Income Source YES NO Amount RecipientWages/Earnings

Self-Employment

Child Support

Spousal Support

Social Security

Unemployment

Workers Comp.

Veterans Benefits

Pension/IRA

Retirement

Tribal Income

Public Assistance (GA, MFIP)

Other

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Funeral and Burial Services RequestedIt is Cook County’s policy that cremation be the first option, unless there are religious or other objections. Do you have any religious or other objections to cremation? YES or No

If YES, please explain:

Please check the service requested:

Immediate Cremation/Burial (No Service) - $1,800

Immediate Cremation/Burial with Service - $2,100

Traditional Funeral with Earth Burial - $2,500

Grave lot (maximum $150) Grave opening/closing (maximum $1,000)

Traditional Funeral with Cremation - $2,500

Grave lot (maximum $150) Grave opening/closing (maximum $1,000)

Please read and initial each statement to show you understand each statement.

I understand that if there are any assets or remaining income, such as Social Security death benefits, this will need to be applied toward the cost of the burial. ______

I understand that the cost of the burial cannot exceed the county burial limits, and that there cannot be any enhancements to the standard county burial services. (However, memorial money collected, not to exceed $100 can be used for clergy, flowers, luncheon, grave marker and other miscellaneous items not part of the county burial package.) ______

I understand that if I knowingly provide false information on this form, I will be subject to prosecution for fraud. ______

I understand that any of the information I have provided on this form may be verified by the county agency. ______

I understand that if I disagree with the County’s decision, I may appeal within 72-hours to the Director of Cook County Public Health and Human Services or directly to the State Department of Human Services. ______

This signed form submitted to Cook County represents an official request for funding, as well as agreement to the above terms and conditions for county burial funds. ______

I certify that the information I provided is true and accurate to the best of my knowledge.

____________________________________ ________________________ Name (please print) Date ____________________________________ ________________________ Signature Relationship to Deceased

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PH: 218.387.3620 FAX: 218.387.3020




Cook County Public Health & Human Services (PHHS) Notice to Family of County Burial Determination

Applicant/contact: _________________________________________

Mailing Address: _________________________________________ (street, city, state, zip) Phone Number: _________________________________________

Your request for a county paid burial for ______________________________________ has been: (name of deceased) ______ Denied Reason for this action: ___________________________________________________ ______ Approved The following service is approved: Immediate Cremation/Burial (No service) - $1,800 Immediate Cremation/Burial with Service - $2,100 Traditional Funeral with Earth Burial - $2,500 Grave lot (maximum $150) Grave opening/closing (maximum $1,000) Traditional Funeral with Cremation - $2,500 Grave lot (maximum $150) Grave opening/closing (maximum $1,000) Available income/assets to be deducted from County payment: $______________; deceased’s family/representative will be responsible to pay the funeral home this amount. Cook County will pay funeral home $__________________ (approved service less available income/assets). Funeral Home: _________________________________________________________________

Address: ______________________________________________________________________ If you have any questions regarding this determination, please call Cook County PHHS at 218-387-3620.

__________________________________________ ______________________

County Worker Signature Date _____ Copy to Funeral Home _____ Copy to File/Case Record _____ Copy to Applicant

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PH: 218.387.3620 FAX: 218.387.3020




Appeal Rights You may appeal the action shown on this notice. If you wish to appeal, ask your financial worker to help you with the forms. Appeals must be filed within ten (10) business days from the date of the County’s determination. If you appeal a denial, you won’t get assistance until you either win the appeal or reapply and then qualify for assistance. You may appeal and reapply at the same time.

Rights 1. You have the right to apply. 2. You have the right to have this notice explained to you. 3. You have the right to know why we need the facts we ask for, and how we use them. 4. You have the right to know why you qualify. You may ask how we decided if you qualify. 5. You have the right to privacy.

Responsibilities If you give facts that are not true, you may be charged with fraud. Any facts that you give may be checked by the County agency. Facts that deal with your case can not be requested without your written consent. If you do not five your consent, or change your facts, your application may be denied.

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PH: 218.387.3620 FAX: 218.387.3020




County Burial Request for Appeal

COUNTY FUNERAL/BURIAL FOR: _________________________________________________ NOTICE IS HEREBY GIVEN that the applicant hereby appeals the final order and determination of Denial by the agency, made on the ___________________ day of ___________________, 20______.

Appeal dated this _____________________ day of __________________, 20_______. Applicant is appealing because: ________________________________________________ Signature of Applicant

Appeal Summary

(to be completed by agency)

Name of deceased: ________________________________________________________________

Date of application: ________________________________________________________________

Date of decision: ________________________________________________________________

Reason for denial: ________________________________________________________________

Eligibility worker: ________________________________________________________________

Supervisor: ________________________________________________________________

Decision of Director: □ County burial approved □ County burial denied _______________________________________________ ____________________________

Cook County PHHS Director’s Signature Date

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