[0:01] need to order. And the first item is to review and approve the agenda. Is

[0:06] everyone had a chance to take a look at that?

[0:11] » Okay, I need a motion to approve. >> I'll make that motion.

[0:16] » I'll second. >> Have a motion, a second. Any other

[0:19] discussion? All in favor say I.

[0:23] » Opposed. Motion carries. Next item is the approval of the minutes of the June

[0:30] 2nd, 2026 meeting. Is everyone had a chance to take a look

[0:36] at that? Are there any additions or corrections to the June 2nd, 2026

[0:41] meeting? Okay, hearing none, I will put those

[0:46] minutes on file. Next is citizen comments. I don't think

[0:52] anybody is online and there was no one here in person

[0:58] unless somebody from the committee has any comments.

[1:04] Okay, next item is the rehab update. Jessica environmental health concerns,

[1:10] food safety and recreation license program update and the water program

[1:14] update. >> I will start with June.

[1:19] » Yes. >> Yeah.

[1:20] » Okay. Um, so the highlights for June, um, was

[1:25] quite a few rabies, um, quarantine animals that came through, a couple

[1:30] specimens tested, but all of them turned up negative, and only a few unvaccinated

[1:36] animals that were uh, had to be quarantined that were part of the

[1:40] quarantine requirements. As far as environmental hazards, the

[1:46] Duck Creek Lane in Westfield, there was a complaint regarding garbage not being

[1:51] contained and scattered around the property. Updatement orders were written

[1:55] and were to be completed by July 9th. Um and as you will see that did not occur

[2:03] in July but um this property is under a taxdeed

[2:10] um situation. So it is being dealt with in other ways also. Law enforcement had

[2:17] called and requested some information regarding a ne neglect case on some

[2:22] tortoises. And so it was mostly just discussion that was had with the officer

[2:27] that was on scene um while the humane officer was out uh not on duty that day.

[2:33] Um but he was the one to follow up with that situation and uh take care of it.

[2:38] So no orders were written upon that. Uh we created a handout for mold for our

[2:45] citizens only because there's lots of places you can get information but ours

[2:49] was to provide a very centralized area of the most asked for information. As

[2:54] you can see down below we got a call again that month but previous months

[2:59] kind of it's the time of the year we get a lot of calls for mold and questions

[3:03] about how to deal with it. What should they do? Who can they contact? Should

[3:07] they test for it? So, we put all that information together. Um, I don't

[3:13] believe it's up on our website yet, but it will be under the environmental

[3:16] health stuff so that it's easily accessible for individuals to get that.

[3:21] But whenever we get a call, that is something that we provide out to them.

[3:24] Now, >> a question. Um, do you know what

[3:27] buildings they were? What kind of buildings they were? Were they house

[3:30] » a housing? Usually, it's always housing complexes or a just a a single family

[3:36] dwelling. >> Oh, okay.

[3:39] Um there was an apartment complex in Montello that um Amber had received a

[3:44] complaint regarding cockroaches in the unit when she had contacted the landlord

[3:48] and maintenance individual. They were already aware of the issue. They've been

[3:52] dealing with a professional pest control person already prior to this complaint

[3:56] had somebody in there, but they're also working unit by unit to get services in

[4:01] each unit. And so for that to happen, the tenants have to let them in and

[4:06] prepare their unit for the service to be done. Um so no orders were written upon

[4:12] that. And in June, we attended the dairy

[4:17] breakfast or I guess I did um providing some information on water testing,

[4:22] ticks, um disease and gave out tick kits and then harm reduction resources

[4:28] for food and safety um or food safety and recreational licing or FSRL.

[4:38] Um we completed our 100% of our inspections. So June is the end of our

[4:42] licensing year coming to July 1st is the start. Um this is the first time for our

[4:48] program since the 2018 2019 licensing year. Um when we were previously Tri

[4:54] County, we have not completed 100% since then. Um so that's a pretty big

[5:00] achievement um for us and hopefully to continue that. Um we did a mandatory

[5:08] webinar uh Jamie and I attended for our evaluation updates from the from DACAP

[5:14] that required us to sit through and just talk about what they are going to

[5:18] require from us um all the documents that they need when they do their audit

[5:22] in the fall each year um for self assessments and information. So, because

[5:28] they've updated that, we all had to attend that. And then we provided a

[5:32] proctor exam for one of our operators um so that they could get their certified

[5:37] food manager certificate for their facility. And as you can see, we

[5:41] followed up with quite a few inspections to round out that 100%

[5:45] um for all of our facilities, but that did get everybody taken care of.

[5:52] And then for as far as the water lab, um we had um a few more private well

[6:01] samples. Wow, that really messed up, didn't it? Um so the ones that are kind

[6:05] of staggered way to the left, those are the the um transient wells that we are

[6:10] contracted through the DNR for. Um so we did 26 of those um were bacteria and

[6:16] nitrates. And then on the the left side that are in that column, it is privates.

[6:21] And so 32 bacteria and 31 nitrates. There is some people that they just want

[6:25] to have their bacteria done or they just want to have nitrates done. So that's a

[6:29] little bit why you see discrepancy with that. Um and as far as the TNC sanitary

[6:36] assessments, those are done every five years and is required by the DNR. Um so

[6:42] we do uh more complex uh inspection of the well unit um the well head its pumps

[6:50] um the pressure tanks as as long as well as sample the water for testing and

[6:55] stuff like that and then we submit that to the DNR for them to review and also

[7:00] the operator or the facility owner gets that um also if we don't do a five-year

[7:06] assessment they get an annual assessment and that we did 23 of them that month.

[7:11] Um, a lot of times in June that is a lot of our um, campgrounds or facilities

[7:17] that close down and shut their walls off so they are seasonal and have to start

[7:22] them back up. So that's why we get a lot of them about that time of year.

[7:27] Okay. Um, for July,

[7:34] uh, still quite a bit of quarantine orders issued. This is kind of the

[7:37] typical thing for summertimes as people are out and about. We did have one um

[7:42] specimen submitted again negative um for rabies. I have joined a workg group that

[7:50] Waldab has put together um that's looking for creative ways to

[7:57] um address the ongoing issue of limited or

[8:03] nearly none of having quarantine facilities anymore. So there's a lot of

[8:08] agencies out there, they don't have a dog pound or a shelter that helps them

[8:14] with quarantine as we do here in Marquette County. So in that case, they

[8:19] don't have vets that have quarantine options. And so a lot of times they're

[8:23] quarantined at home which is against the statutes and does leave a lot of legal

[8:29] issues to be um if the dog were to get out and escape and we can't follow up on

[8:35] or if it would bite or scratch somebody else again there's another like setback

[8:39] to that of a longer quarantine. So this work group is is working with DHS um the

[8:47] state vets um epidemiologists and other agencies to create um when you do home

[8:55] quarantine what are the guidelines you have to use to make it so that we're

[9:00] trying to make it as safe as possible when these facilities don't have this

[9:03] even though it's still not following the statutes and we have been well told that

[9:09] um the state vets don't support it because it's outside of the statutes and

[9:12] the limits. Um hopefully we'll be able to um Wald wants to lobby for changing

[9:19] some of those statutes and verbiage. But until that happens, we do need to

[9:26] require our animals to be quarantined when they're unvaccinated versus

[9:32] quarantined at home when they're vaccinated. Even if we do quarantine at

[9:36] home, there still is specific guidelines in the statute that you need to follow.

[9:40] And so some of these guidelines help with that.

[9:44] Um, Environmental Freedom Road in Oxford,

[9:49] they re we received a complaint on garbage being scattered about. Um, so

[9:54] vacant orders were written and due in August and you will see they completed

[9:58] those in Montello. It was the um, uh, complaints regarding pigeon

[10:05] infestation of a rental affecting their individual's house. um that individual

[10:11] had been diagnosed with um a disease that is directly affected

[10:17] by being coming into contact with this dust from the feces of pigeons and other

[10:24] birds and vermin. So, I did contact and collaborate with DHS and BEOH, which is

[10:30] the Bureau of Environmental Occupational Health, um, to gather some information

[10:36] about testing needs, like do we need to test the excrement? Um, because the

[10:40] landlord was taking care of it, but we also want to know, is this truly where

[10:45] she was getting the exposure from, the individual work from home, so they're

[10:49] there all the time and don't go other places, so it's assumed yes. Um,

[10:55] however, they still um did not recommend testing. They just would also assume

[11:02] that that is because they didn't want her to be um exposed to it anymore and

[11:07] gave me more information on how to contain the exposure and clean up

[11:11] afterwards for that individual and and um let the landlord know how long this

[11:17] individual needed to be outside of the unit and what needed to happen to clean

[11:20] it up. So, no orders were written. the landlord was very um immediate to

[11:27] respond to the issue and get it cleaned up and and things like that. So, and

[11:32] more than willing to take the precautions needed. So, um I just help

[11:36] them work through that. The apartment complex in Montello, we got another

[11:41] concern or complaint regarding the cockroaches. However, management is

[11:46] still working with the professional. They had been doing more of the

[11:50] abatements. However, not all of the tenants we were finding out are being as

[11:55] accommodating to the process and so that's leading to um the abatement

[12:00] taking a little longer. So, we did have some conversations with those tenants.

[12:07] We provided information at Baby 101 and attended on water testing, radon, and

[12:12] lead testing and that went really well. Um, as far as the FSRL report, we I did

[12:22] provide some information to our food facilities regarding the obviously, as

[12:27] you guys probably heard on the news, the big cycllospora outbreak um with lettuce

[12:31] and things like that. So, a lot of them were asking information and so I wanted

[12:35] to keep them updated with where it was coming from because at the beginning

[12:39] they weren't they hadn't pinpointed, you know, the distributor or what

[12:43] information and the type of lettuce and stuff. So, or what it even was. They

[12:48] didn't know if it was lettuce, tomatoes or any other type of greens. So,

[12:52] provided them that information just so that they could take as much action as

[12:57] they needed to on the products that they serve and the best way they could. um

[13:03] provided the second quarter newsletter to all of our licensed facilities. This

[13:07] is a newsletter that gives information to each types of operator, food,

[13:13] lodging, tattoos, campgrounds, wrecked. So, it's something specific that's kind

[13:18] of going on with that time of year um to give them some useful up-to-date

[13:23] information and um help them improve their facilities. Sometimes operators

[13:29] ask for a certain thing. Otherwise, if we see certain violations popping up, we

[13:34] kind of um navigate to pinpoint information on that topic. Dakota Road

[13:41] in Westfield, we received a complaint about an operation of an unlicensed

[13:46] campground and tourist rooming house. So we did issue a cease and desist cease

[13:51] and desist letter for both of those facilities and informed zoning because

[13:56] they also license the tourist room houses.

[14:00] Owner removed all the advert advertisements and is not going to

[14:04] continue um to operate those and continue or wants to does not want to

[14:10] license them. So no further action. It's been considered closed.

[14:15] Um a few attended webinars that we got to um attend is about smoked fish at

[14:21] retail and religion culture with food. And then I attended a FDA assessment and

[14:27] verification workshop. This is a program that DACA um quote unquote says is

[14:33] voluntary, but it is more like volunttold that we need to do. And it it

[14:38] helps us provide um a written documented way to show our

[14:44] operators and you guys and the community that we are following a policy and

[14:51] procedure to do things in a certain way that we're um checking each other's

[14:56] reports that making sure that we're being um

[15:02] » consistent and that if we need to collaborate with the state or the FDA

[15:07] that we're doing that. So, there's nine different standards that you have to go

[15:12] through and assess off of your policies and procedures to see if you are doing

[15:17] all these things and submit it to them. And so, um part of that is we wrote we

[15:22] wrote for a grant and got approved for that to do that so we can do that work

[15:27] to show that we're we are following. I've not completed the assessment yet um

[15:33] for all nine. That is due by March of next year. So hopefully that will be

[15:37] something we work as a group to go through and do um to find out where the

[15:42] deficiencies are in our policies so we can buff those up and um make sure that

[15:47] we're doing the best and help support our program to be better in any way

[15:52] possible. Um quite a few inspections as the start of the year. That's a lot of

[15:57] campgrounds wreckads those seasonal pools um that we got to get to before

[16:02] they close down for the season. And then for the well inspection,

[16:09] have to deal with something with this. Um, so we lost power during one of the

[16:14] few storms that we had after we had just collected a bunch of samples. So, um,

[16:20] our incubator had went down. So, because of that, we had to deem all those 16

[16:26] samples invalid and recollect them. Um, so we did talk with Danny and um

[16:32] procured a battery backup pack for that unit and it's already installed. They

[16:37] did it immediately pretty much um so that we don't have that risk. And what

[16:42] the problem is is even though we have the generators, it's that um short blips

[16:48] of the generator turning on that it resets that whole unit unfortunately. So

[16:53] the battery backup is just to hold it so it doesn't and then gets power back from

[16:58] the generator. So we don't have that fluctuation. There's only one degree

[17:02] fluctuation you can have in the incubator during these sampling periods.

[17:06] So it's pretty darn small. Um and anytime it reads outside of that, we

[17:11] have to deem it invalid. Um so we had not as many private well

[17:18] samples. We only had 11 bacteria, 12 nitrates. Um, we did have a few

[17:24] confirmed positives. That's meaning that they had tested and it was positive and

[17:30] retested and and still positive um not from a contamination of collection. And

[17:38] so then we had one individual that had nitrates higher than 10 milligrams per

[17:43] liter, which is the EPA limit of nitrates that we want to have. For the

[17:47] TNC's, we did 37 bacteria. And you see the jump because of the extra bacteria

[17:52] we had to do for sampling. We count each one of them no matter what because we do

[17:56] have to use packets um to make those work. And um we only had one nitrate

[18:03] sample that came back high. This indivi this individual facility already knows

[18:08] that they have a high nitrate. And we did have a positive that we worked with

[18:13] them to um ensure that we they chlorinated and got rid of a deadend um

[18:19] pipe in their their well system. But we did a couple of sanitary surveys and a

[18:25] lot of the assess annual assessments.

[18:30] And then finally for August,

[18:34] not as many quarantines, but we still had one specimen submitted. Um, this was

[18:40] for sure a bat. I know I remember from last month. So, it's also that time of

[18:45] year, um, where we're going to start seeing some more bats being out. So,

[18:49] that's not uncommon. We had an open records request regarding an animal bike

[18:55] history on a specific animal, and so that was um provided to the uh,

[19:00] insurance agency that requested it. And then

[19:05] um the wellwater kit, the two um tests that

[19:10] these are tests that are done for individuals that have a pregnant mom in

[19:16] the house, a baby under one or an infant. Um and they their test both came

[19:22] back with higher nitrate levels. So we provide them in education information

[19:26] about that. And then one had bacteria. So they are resampling to ensure that it

[19:30] was contamination from sampling and collection not a true contamination.

[19:37] As far as for environmental um Freedom Road that uh we conducted an

[19:43] on-site visit and all the garbage removed, so we released that order and

[19:48] Duck Creek Lane. Um we did have a meeting with multiple department heads

[19:54] and administration to discuss next steps on that property. Um

[19:59] I will be issuing um condemning orders for that property

[20:04] due to a failed septic um that has been uh confirmed by zoning department and

[20:11] then um an on-site investigation will be also happening at some point. the former

[20:17] Lions building and the former Nifty Thrifty in Pacwocki. We've received

[20:23] complaints on kind of shortly within each other's uh regarding the

[20:28] deterioration of the buildings and requesting if we would did an inspection

[20:34] for these facilities um because they were concerned about health hazards and

[20:39] being dilapitated. Um we were in um informed that DSPS has

[20:46] already been um contacted and a formal complaint has been submitted and I have

[20:52] reached out to them. However, I've not heard back with them yet as if there's

[20:56] any collaboration required. Um but it sounds like a lot of this is structural

[21:00] things. So most likely DSPS is going to have to do that and um on-site

[21:08] investigation. if they want, we can do more if they can provide us um

[21:13] information that it is uh structurally unsound. However, nobody

[21:19] lives in the line building, Lions Club building, the former one, but the Nifty

[21:24] Thrifty, there's a residential area in the side or back, I guess, however you

[21:29] want to look at it. So, that might be something that we could get involved

[21:32] with if needed to. Um, Dakota Lane had multiple contacts with law

[21:40] enforcement regard regarding if this property has a kennel license, which

[21:44] does. It's had one since 2022, and there hasn't been any um violations

[21:51] to the kennel license or charges that would affect that license. Um, so no

[21:57] action has been taken at this time. Um I we participated in the 140 review

[22:05] for the health department and that went really well I believe. Um as far as our

[22:10] FSRL report for the month. Um Third A and Endeavor received a complaint

[22:16] submitted to DACAP regarding an illegal farm baking good stand. Um we did an

[22:23] on-site visit and we provided some educational information there. However,

[22:29] um the complaint was that they were providing

[22:32] goods that are not allowed in that cottage baking law, which is goods that

[22:38] should be kept under refrigeration or isn't made in a dry chamber such as an

[22:44] oven. Um during our visit, we didn't see any of those there, so we just left the

[22:48] education information and our contact information um and let them know why we

[22:52] were there because nobody was available around the stand. So that's all that we

[22:58] did for that. Um we submitted our annual reimbursement to DAC CAP and this year I

[23:03] believe that reimbursement was 13% right. Okay.

[23:06] » Um so that is all done. And then as you can see still rounding up some of those

[23:12] seasonal facilities. Lots of inspections being done and followed up on. And then

[23:17] lastly for a well report, we had one individual that called us asking about

[23:23] um lake the lake water testing and safety of the lakes. So we obviously

[23:29] don't do any lake testing here. There is some specialty testing that you can do

[23:34] for lakes. It is offered at the wheel lab in Stevens Point. Um, so we did give

[23:39] them that information, but also the DNR does have information on their website

[23:43] about monitoring and what they're looking for in each lake and how often

[23:47] it gets monitored, but that is more of like a a citizen monitoring. It's it's

[23:53] voluntarily done. It's not required to be done by anybody. So,

[23:58] um, they were just wondering if that particular lake, and I'm not entire even

[24:03] entirely sure which lake it was, was safe to swim in or or recreation in. and

[24:08] stuff. So, um, again, a few private wells, 15 for

[24:13] bacteria, 13 for nitrates, and then for the TNC wells, 29 bacteria, and 20

[24:21] nitrates. And you see a few extra bacterias because each quarter we may

[24:26] have to do quarterly testing on some and that is um for those facilities. And

[24:31] also we had um a confirmed positive and so that's where those four positives

[24:36] come from is so after you get one confirmed positive which you seen in the

[24:40] last month's review you have to go back and do follow-up testing and those were

[24:46] still positive um after a chlorination and removing. So they need to do another

[24:52] chlorination and flushing of that well and we'll go back out as the DNR

[24:56] requires to do another collection of that.

[25:02] » That's it, right?

[25:07] Jessica. >> Yeah, I just had a few quick questions

[25:12] here regarding the power backup that caused problems for the incubator. I

[25:17] know that uh the health department also keeps refrigerated items that are

[25:23] potentially problematic if they they lose that. Are they not as sensitive?

[25:29] Okay, >> they're not as sensitive, but the other

[25:31] issue is that the equipment itself our our vaccine cooler is able to handle

[25:36] short blips and interruptions in the electrical or the power grid. The

[25:40] incubator is not able to handle that. if there is any sort of blip in the

[25:44] electrical current then it will completely reset and if it resets it's

[25:49] not at the standards and temps that that the program requires. So

[25:52] » it resets on that heating element that it takes time for it to heat back up and

[25:56] that's the part that resets and unfortunately because that degree is

[26:00] only one that we get to play with. It's set at a very um it doesn't take long

[26:08] for it to go back down and not power back up right away and start heating and

[26:12] maintaining that temp. >> Are you do you feel confident that

[26:17] that's fixed now with the backup that you have?

[26:20] » Yes, we I've watched them um in the mornings when maintenance does their

[26:25] testing of the generators and turns down and powers those up. I've seen it not

[26:31] affect it anymore. So, I'm hoping that means as long as the generator comes

[26:36] back on when it's supposed to, as quickly as it usually does, always has,

[26:40] um, that it won't affect those. >> Then, a question about animal control.

[26:46] This has come up in a number of different meetings that it's becoming

[26:49] increasingly difficult to deal with animal issues.

[26:53] Few couple questions on that. Does the Department of Health generally deal with

[26:58] animal welfare issues or is that kind of an anomaly that you'd be talking about a

[27:03] a tortoise with the >> It's more of an anomaly and the only

[27:07] reason I think this individual law enforcement called me was because of my

[27:13] um previous background as a certified vette and so they knew of that and had

[27:18] called and made a conversation with me because that humane officer on otherwise

[27:21] it is typically the humane officer that deals with them. Then regarding the

[27:26] quarantines that happen with the rabies animals and the difficulty of finding

[27:30] places to to do that, does anyone have a background of the history of how this

[27:35] used to work and what's changed and why has it changed?

[27:39] » Um, it's been working the same way for a long time. The statutes has not changed.

[27:44] However, um, fewer and fewer veterary clinics provide quarantine, if not none

[27:51] of them don't anymore. Um, and we're seeing less and less shelters, which

[27:56] used to help out with quarantine. And same thing with like dog pounds or

[28:01] quarantine facilities themselves. They're just not substaining. um so that

[28:07] they're no longer available um in Appleton and

[28:14] um out of Gy County and over in that area um Fox Valley area, they don't have

[28:22] places and so a lot of them are just quarantined at home and we've been told

[28:26] by the state that that if we tell them they can quarantine at home or the

[28:30] officer does that we or that officer could be held legally liable for if

[28:35] anything happens. like the dog goes um vanishes or gets loose and now we can't

[28:41] find out did it die? Did it is it okay? And this individual, whoever the victim

[28:46] is, would possibly have to go through the prophylactics or any other care.

[28:52] » So, what you're saying is vets used to do it, now they're not. There used to be

[28:57] um shelters that are closing, so they can't do it either. Mhm.

[29:02] » So I mean rabies is something that's been around forever and it probably will

[29:06] continue to be. So this is an issue that not necessarily the board of health but

[29:11] it needs to be dealt with somehow. So it just has me thinking what the solution

[29:17] could be on this. And I know Waldab is um working really hard to lobby against

[29:24] some changes in the statutes um because there is other states that provide

[29:30] different things than our Wisconsin statutes. Um so that is something that

[29:35] they're trying to get changed um but it's to get it changed by the lawmakers.

[29:41] And as far as board of health goes, what your a potential involvement might be is

[29:45] that if you know, Waldab is advocating to Wisconsin DHS to make some changes to

[29:51] statute to make it a little bit easier for people to quarantine at home versus

[29:55] having to find a licensed or legal quarantine facility. That might be

[30:00] something where we would come to board of health and say, "Hey, can you please

[30:03] pass a resolution that supports their efforts in doing this? We would really

[30:08] like to see these statutory changes made so that things can be done safely and

[30:12] legally. Um, but you're right, outside of advocating for something that we find

[30:18] important in Marquette County, there's there's very limited influence that we

[30:22] would have at this local level. We just do the best we can with

[30:27] resources that they have. I guess my question would be on the

[30:32] quarantine is um the vets seem to be the logical place to have it. They have the

[30:39] facilities, they have the everything there available. What's the hurdle of

[30:44] why or what's the obstacle why they don't want to do it besides money? Uh

[30:51] staffing because you need 24hour um or staffing and facilities. A lot of them

[30:56] don't have runs or able to kennel them for 10 days. Um, having staff to care

[31:02] for them outside of their regular clinics hours um that can handle, you

[31:09] know, making sure the dog is being monitored for some signs and symptoms.

[31:12] And um a lot of times it is a facilities or the caring of the animals themselves

[31:18] because a lot of vets don't have groomers on hand or do doggy boarding,

[31:23] daycare or animal boarding of any facilities. They just provide veterary

[31:28] care um or emergency care. >> So I agree with John. It's becoming a

[31:34] bigger issue statewide, I think, and something has to be done because we've

[31:42] got that situation right here. So, Gary, >> um, you said that you don't water test

[31:49] lakes. Understandable. What does the city of Montel uh, is your service

[31:54] available to them now for their city water system or do they still have to

[31:57] use some other private >> Yes and no. for water testing for the

[32:02] public water of the city. >> They could use us for bacteria and

[32:05] nitrates, but that's it. Um the rest of their testing would have to be sent out

[32:10] as for nitrites and um arsenic fluoride um and any other kind of heavy metals or

[32:18] inorganics would be sent out because we're only certified for the bacteria

[32:22] and nitrates. I'm only asking in in case there would be a little budget break for

[32:26] the city by working through you. >> And same thing with um

[32:33] any well drillers or um pumped installers, they can also bring them

[32:37] here. We're certified to do those um tests as they need to. So, we have

[32:42] provided that information out there to them just so that if they don't already

[32:46] work with a lab or have a contract with a lab that they can do that they can

[32:51] bring them here locally instead of driving. But sometimes they have a lot

[32:54] more sampling to do and it's feasible for them.

[32:58] » Thank you. >> And speaking with Montello, they didn't

[33:01] think that bacteria would probably ever be an option just because when they have

[33:05] to do their bacterial sampling, they're testing for all of these other things

[33:09] that Jessa just talked about and it's easier just to make one big package,

[33:12] send it off where it goes. But for nitrates, there's a potential for more

[33:16] conversation. So, >> it is something also if we ever have

[33:20] like a flood or a natural disaster, something we could um it's something

[33:25] that's being put into our coupe plan now is that we could use the lab for doing

[33:30] testing to make sure private wells or community wells are okay to be used

[33:35] instead of having boil water noses because we can turn them around in 18

[33:38] hours. >> Any other questions?

[33:43] Thanks, Jessica. Right. On to new business, the highdose flu vaccine fee

[33:49] increase. Jamie. >> Yes. So, um, we are asking for the board

[33:56] of health to approve an increase for our highdosese flu vaccinations this year.

[34:02] Um, it should be noted before we get into the dollars and cents of it all

[34:05] that this is a Medicaid reimburseable service that we have. So, it's $0 out of

[34:12] pocket to the client always. Um, but when we go to bill for those services,

[34:18] you can only bill what your fee schedule says. So, we can't bill for more than

[34:22] what it is our our fees say. Um, so our current

[34:27] um fee for the highdosese flu is 112, but we have recently seen an increase in

[34:33] what we're able to bill for reimburseable services. And so we're

[34:38] asking for an increase to to $150. So from 112 to 150. This will have a net

[34:45] zero impact on out-ofpocket costs to our customers. It's just that again we can't

[34:52] bill more than $112 to the state if our fee isn't higher

[34:58] than $112. So this will help with with reimbursement to the county and improve

[35:03] upon our revenues.

[35:08] And we have these we have a couple um fees that we're asking for approval for.

[35:13] We do have them broken up separately, but you guys can decide if you need to

[35:16] finagle that. Questions?

[35:23] Then a motion will be in order to increase the highdosese flu vaccine

[35:29] fee from $112 to $150.

[35:37] I'll make a motion. >> Okay.

[35:39] » Second. >> Motion a second. Any other discussion?

[35:44] » All in favor say I. >> I.

[35:47] » Opposed. Motion carries. >> Foot clinic fee increase.

[35:52] » Yes. And before we jump into that, I just want to point out because we do

[35:55] have, for those of you who have either been on our board or have been paying

[35:59] attention to what we're our offerings are at the health department, we are not

[36:03] asking for an increase for our standard dose this year, but what it is that

[36:07] we're charging currently should still get us a good turnaround on

[36:10] reimbursement, and it's about as much as we're able to ask for. So, we're not

[36:14] asking for that this year. Okay. So, on to foot clinic. Um, we did look at an

[36:21] evaluation of how much time it is that we're spending offering these services.

[36:25] Um, I did have Melissa go through and do an evaluation of how much we're spending

[36:30] on the supplies. So, the glutalahhide, the Dremels, all of the the sanitation

[36:35] um, equipment that we have. And there there is a slight increase in what it's

[36:41] been costing us. And so, the last time that we had asked for an increase for

[36:46] this item was 11 years ago. it was when I first started as health officer. And

[36:50] so, um, we're asking today for an increase of $5 to the cost of that

[36:56] service. So, it would go from $30 a visit up to 35. Um, our current fee

[37:02] schedule is set up such that a firsttime visit is a little bit more expensive

[37:07] than, you know, your maintenance visits. and we did away with that just to have

[37:11] it consistently be 35 for every appointment, whether it's your first

[37:15] appointment or the fifth time you've seen us this year. So, we're trying to

[37:19] keep it simple for people, but the cost of offering that service has gone up a

[37:23] little bit with cost of supplies and and all of that fun stuff. So,

[37:30] questions, comments? Okay. Motion is in order to increase the

[37:37] fee for the foot clinic from $30 to $35.

[37:44] » I'll make the motion. >> Motion second. Is there a second?

[37:49] Any further discussion regarding that motion? This is a good program. Um it

[37:54] does generate revenue and it's not just a matter of increasing the fee

[38:01] $5 just to increase fees. Um I think that this has been very well received

[38:07] and I don't know how much time it takes to do um each one of these patients, but

[38:14] uh I don't think a $5 increase is unreasonable for this case.

[38:20] Anything else? Okay, we have a motion, a second.

[38:25] All in favor say I. >> Opposed? The motion carries.

[38:31] Okay. 2027 health department budget. Yes. Um, and before we jump into that, I

[38:40] just want to give the board a heads up about um some some of our fees moving

[38:45] forward that we're not asking for approval for right now, but that will be

[38:48] coming down the pipeline. Um, many of you are aware that we also have our

[38:53] rehab program, but the the fiscal year for that program is July through June.

[38:59] And so we tend to wait until February, March to approve the full fee schedule

[39:04] for that program. So that'll be coming down the pipeline in a few months. We're

[39:08] trying to get everything else covered now, but that that will be later in the

[39:12] year. Um, and since we're already going to have to come to you for some fee

[39:17] changes potentially, um, we are also looking at the potential of either

[39:23] increasing the fees for B vaccination services or eliminating that program

[39:28] altogether. The um the cost of just the raw materials, the actual vaccines

[39:34] themselves have skyrocketed. And so it's not quite as popular of a program as it

[39:39] used to be. We haven't quite we still have vaccine available. So, we're going

[39:44] to relook at it when we're getting closer to needing to reorder, but I just

[39:47] want you to know that that's something that's in process and we may have to

[39:50] bring up again in um February time frame.

[39:55] » John, >> how many different kinds of vaccines do

[39:58] you currently offer? >> All sorts. Do you have a plan exactly?

[40:02] » I don't have. We do a lot through the VFC program, which is where we're

[40:07] limited to who we can offer them to. We do purchase like the flu, the HEP, the

[40:13] TB. We don't purchase out of our own pocket as many. It's mostly the program,

[40:20] the BFC and the BFA program. Mel, who usually is in here, is our

[40:26] vaccine coordinator, and she would have exact amounts for you, which we can get

[40:32] if you need them. >> I was just wondering.

[40:34] » Yeah, but we do we do have to keep them separately even if we have the exact

[40:38] same vaccine that's part of the state funded program and we have some that are

[40:42] private pay. They have to be tracked separately, kept separately. So, as much

[40:48] as you know, we may have 20 different types of vaccines, sometimes they're

[40:52] split into different programs, different storage requirements, different

[40:55] reporting requirements, and so um and of course, obviously, some vaccines come as

[41:00] multi-doses. Some of them we also have as single doses. Um it's just what what

[41:06] people need and what they're able to uh you know, pass for at that time. So,

[41:16] so then moving on to health budget.

[41:23] So, um I am not going to I'm sure board of health members, you guys saw board of

[41:28] health orientation um presentation in your materials and we're like not again,

[41:34] right? Um we're we're we're not doing it again. I just wanted it to be I know I

[41:40] know guys as fascinating as it was. It's a long that's a long meeting. Um but I

[41:46] did want to make sure that it was readily accessible to you if um anything

[41:51] came up while we were going through the materials. But what I am going to start

[41:55] with for you guys is

[42:01] um is to start with

[42:06] the budget support document. So this document does reference board of

[42:13] health orientation information which is the again the only reason why I included

[42:17] that document in your um in your packets for this month. Um, but I wanted to make

[42:22] sure that everyone knew exactly where to find where our statutory mandates were.

[42:28] Um, obviously in the orientation um, PowerPoint that's covered on slides

[42:36] 12, 13, and 14. And then the programs that are offered are also on there.

[42:40] That's an overview of our foundational public health capabilities.

[42:45] I'm not going to go over this. I just want to make sure that you all know

[42:48] where they are and and where that can be referenced if you want to look at it

[42:52] later, but I do have all of our mandates listed

[42:58] here in a very brief overview. So, if anybody needs anything more um more

[43:04] complex or wants to talk more specifically, we can do that. But so

[43:08] then what I wanted to talk to you guys about going into this budget season is

[43:12] how it is that we hold ourselves accountable for our programs and whether

[43:16] or not we should be having them or not. The the health department does have a

[43:21] policy. It is within our strategic plan that we are evaluating all of our

[43:25] programs for whether or not they are required or we should be offering them

[43:30] at all. So annually, third quarter each year, we go through each of our programs

[43:36] and we look at whether they are mandated, which means that they would be

[43:39] either a statutory or an administrative code requirement, whether they are a

[43:44] CHIP priority, which is our community health improvement plan. Um, the CHIP

[43:50] process is mandated. However, the things that the projects, the efforts that come

[43:56] out of it may not be, but they are still required as part of that CHIP process.

[44:01] So, if they're a CHIP priority, they're listed. If they are part of our

[44:05] strategic plan, which is also a mandate, but again, the specific things that come

[44:08] out of it may not be. So, we, you know, pull those things out separately so

[44:13] people can see which ones those are. And then we have another category which we

[44:18] call a criteria match. And basically what that is is programs that and and

[44:25] the programs that are in this this uh category are often the only programs

[44:32] that are bringing in funding to the health department for non-mandated

[44:35] programs. But a criteria match is one that meets all of the following

[44:40] criteria. We have to have the time and capacity for it. Generally for us that

[44:46] means that it ties into something we're already required to do, something that's

[44:49] important for us to be working on. There has to be funding tied to it. Um so no

[44:55] matter how important it is, no matter how much we think it's something we

[44:58] should be doing, if there isn't funding tied to it, it's automatically a no. And

[45:03] then um it has to have requisite partner engagement. So, if it's something that

[45:08] we think is really cool, but we're going to be banging our heads against a wall

[45:11] because we just don't have enough own from either the community or the

[45:14] partners we would need to be working with or say for instance, board of

[45:18] health is like that's a loser. We don't want that. If we don't have that kind of

[45:21] support, then that's automatically a no as well. So, all of our programs go

[45:26] through this on an annual basis and then we categorize them in a spreadsheet,

[45:32] which again, this is this is in that document that I have for you. I'm not

[45:36] going to go through each one. Some of these meet multiple

[45:41] different categories. Some of them may be a chip priority. They may also be um

[45:46] a a category or criteria match program. I generally put the one that is most

[45:53] required if you have to just select one reason for it to be on there. But we did

[45:57] use this process to go through and determine which programs we were going

[46:01] to drop um when we lost staff people a few years back. And so again, we

[46:07] utilized this as sort of the strategic process in determining what stays, what

[46:13] goes, and what we can continue to support in public health.

[46:17] So again, just to make sure that you're familiar, this is part of something that

[46:21] we do annually and we do try to be accountable and have a way of showing

[46:26] that. And I'm sorry guys, whenever you um put

[46:31] documents on SharePoint, the formatting gets a little bit weird, but I wanted to

[46:35] as part of this process for budgeting to show you where our um our public health

[46:41] contracts are coming from. We have two that we um that we have had for now

[46:47] decades at this point. Optum, which is $32 a month, and that is the program

[46:52] that we require in order to bill MA for our services. You have to have some kind

[46:56] of billing platform to do that. Optimum is the one that we use. Um I have been

[47:02] doing this in this position for 11 years. It has been $32 a month for 11

[47:08] years. So we've been fortunate that we haven't seen hike um a hike in rates for

[47:13] that. Um the other contract that we have through public health is through our FEP

[47:20] consortium which is public health emergency preparedness. Um the emergency

[47:24] preparedness program is a mandate. This consortium is not necessarily. However,

[47:31] what this group does for us is they create they generate all of our all

[47:38] hazards plans. So, public health is required to maintain hundreds of pages

[47:43] of plans for how we would deal with any kind of hazard that may happen from

[47:47] chemical warfare to you know public health um diseases spreading to having

[47:55] wildfires and tornadoes whatever it may be. there are public health aspects to

[48:02] recovery um an initial way of responding to those things. This consortium goes

[48:08] through and creates all of those plans for us. It is a heavy lift and so we

[48:14] have a grant that covers it. Again, we've been part of that consortium for

[48:18] probably 15 years at this point. They have not increased our monthly fee for

[48:22] that. Um there is no levy impact. it is covered by a grant and then the

[48:27] remainder of that grant pays for one of our nurses to make sure that those

[48:33] things are being integrated within Marquette County. Working with our

[48:36] partners, making sure that you know people are on board participating in the

[48:41] activities and exercises and then obviously making sure that our public

[48:45] health department is compliant with what the state requires. So again, something

[48:50] that we've had for several years, it makes it so that Sarah can do something

[48:56] other than just work on policies, which has been really helpful to us because we

[49:02] utilize her for a lot of um preparations and planning related to FAB.

[49:08] » Okay. Um and then I don't know that I have it on this sheet. However,

[49:14] um I know as part of this process, um administration and the board had asked

[49:20] if we could present to you our capital expenses plan since we don't have any

[49:26] incoming or pending capital expenses anticipated. I didn't put them on there,

[49:31] but I did want to call out the fact that there are a few items that would

[49:36] typically fall into that category. They've just been replaced recently

[49:40] enough that they're not on a replacement track. One of them is our vaccine

[49:44] cooler, which actually died during a board of health meeting last year. So,

[49:48] um, that's just been replaced. It's actually still under manufacturer

[49:52] warranty. So, here's hoping we don't have to replace that in the next couple

[49:55] years. Um, and then our spectr photoometer, which is the equipment we

[50:00] utilize to process our nitrate samples. It's a fairly expensive piece of

[50:05] equipment, but again, we've we purchased it in February of 2026. Still under

[50:10] manufacturer warranty. Should definitely last more than a couple years. So,

[50:14] something to keep in mind, but nothing that's going to come up in terms of

[50:18] expenses. The other thing is is that we do try to plan for these things. We do

[50:23] have a fund 11 account that um we collect very slowly. it it grows at a

[50:31] very very slow rate, but we do collect that funding in case we don't have any

[50:36] other way to pay for a vaccine cooler if it died. So, we've got some backup

[50:39] funding there. And then um with the Spectro, again, thankfully having

[50:45] partnerships for the EH program. Um we've been very fortunate. We've been

[50:50] able to use grants to cover that. Um we certainly could use our equipment loan

[50:54] closet if we needed to. And if we get to a point where we clear out at the end of

[50:59] the year, any money that was brought in at our food safety and recreational

[51:03] programming is required to stay in that account that can't be put back into

[51:08] levy. It's required to stay for that purpose. So if there is any rollover,

[51:14] which we try to avoid, we try to have it be pretty close zero to zero, right? But

[51:18] if there's anything left, that funding can go to support food safety,

[51:22] recreational, water programming. So, um, again, when we get to that point,

[51:26] hopefully we have options for spending. Um,

[51:32] I'm not going to go into a great deal about this because again, we did talk

[51:34] about it during board of health orientation, but there are a number of

[51:38] programs that we offer that we're required to offer that we are not

[51:41] allowed to charge for. Um, or if we are allowed to charge for them, we are

[51:46] allowed to charge $5 for them. These are things that are listed in statute. um

[51:53] and can can make it sort of complex to budget um for a program.

[51:58] » And then funding sources, I listed out each of our um our standard grants, the

[52:04] ones that we generally see renew each year and then also called out a few of

[52:10] the project um grants that we had this past year. So, um, for instance, the

[52:16] DOJ, we had a harm reduction grant, which is a oneanddone, but it certainly

[52:22] did bring some funding into the department. The DNR, um, is it accounts

[52:28] for the majority of what it costs for us to offer our water testing and

[52:33] inspection program. And then, um, American Heart Association, if you guys

[52:38] recall, we had Libraries with Heart funding was for that. And then the fees

[52:43] that we're able to charge as a health department are for programs like um

[52:48] environmental health, flu vaccines, water tests, and then food safety and

[52:52] recreational licensing fees. So then that brings us to the overunder on the

[53:01] public health budget. Um, now rehab, I continue to tinker with that throughout

[53:08] the year because we bill and charge for almost 100% of the money that we get for

[53:15] that program before that license year even starts. So,

[53:20] we put out all of it's probably 90% of our funding. We send all of the invoices

[53:25] out in the May before that program starts July 1.

[53:31] um we can only estimate how many facilities we'll have. We can only

[53:36] estimate how much turnover there will be. Um and so as we get a little bit

[53:41] more of a handle on how many facilities we'll truly have, how many inspections

[53:44] we're doing, I can tinker with those numbers, get something a little bit more

[53:48] um accurate and fine-tuned. But for right now, what we're looking at for the

[53:54] calendar year budget is about $37 $37,000 for REIA. And then program

[54:01] revenue, again, we're always trying to fine-tune it to make sure that we're

[54:04] bringing in exactly what it is that it costs. Um, obviously, we would rather

[54:10] come over, you know, in terms of revenue by a couple hundred or thousand dollars

[54:14] rather than coming in under. And so I do try to be a little bit conservative with

[54:18] my numbers, but we are always looking for for one to one, which is required by

[54:23] DACA cap statute. Um then looking at the overall public

[54:30] health budget, we are looking at 593,000. These are rounded numbers. Um

[54:36] then a grant revenue estimation of about $150,000,

[54:40] $150,000, which is about 25% of the overall budget. and then program

[54:45] revenues of about 40,000. And um we will go into the actual line by line of the

[54:52] budget. I just want to point out that when you look at grant revenue, we are

[54:57] seeing reductions in what the state is now offering. Um we were really

[55:01] benefiting from a lot of those COVID era grants and those are starting to retire.

[55:06] Um so there is that. But then um as far as program revenue, we've seen a

[55:12] decrease in the number of people who are utilizing our flu clinics. So we've seen

[55:16] reduced revenue there. And um so we're seeing some reductions in those areas,

[55:22] but we're hoping that a the fee increases with the flu shots as well as

[55:28] foot clinic will help make up the difference for that as well. So, we're

[55:31] coming in level, but um just know that we're seeing shifts in how our services

[55:38] are being utilized. We are making sure that our to the best of our abilities

[55:42] that our fees are making up that difference. So then as a whole

[55:48] um for all of all of public health reha and the public health department

[55:53] combined we're looking at about $900,000 and a total revenue of um 497,000

[56:00] so about 55.2%.

[56:04] Now does does anybody have any questions

[56:07] before I go to the line by line of the actual budget?

[56:13] All right. So, I'm going to bring that up for you guys.

[56:17] And just so you know though, if you want to follow along with what I'm going or

[56:23] what I'm looking at here, I'm going to be looking at what's called the cover

[56:28] letter. It's listed as number one, cover letter. So, I'll be going through that,

[56:33] but we'll be talking about the budget spreadsheet, which is up here. So, okay.

[56:40] So, in going through um line by line in our budget, you can

[56:46] see obviously the top what is that five or six lines are the personnel expenses.

[56:52] Obviously, we're going to see increases in those line items because the cost of

[56:57] having employees and having health insurance for employees consistently

[57:01] goes up each year. Um the difference in salaries is a little bit less than it

[57:06] typically would be, but we did have some turnover with a staff person. Um and

[57:12] then obviously the incoming person is making a lower wage. So that makes up a

[57:15] little bit of that that difference that we would probably see in a typical year.

[57:20] Um FICA, Medicare, retirement, we don't really have any any say over that. They

[57:25] just increase from year to year. Um the health insurance premiums are obviously

[57:30] going up in a pretty significant way. I believe 11% is that correct that we're

[57:35] anticipating for Okay. Um this is for the public health budget and the public

[57:41] health budget is not um is not looking at any qualifying events for staff. So

[57:47] that $15,194 it's increasing is only because of that

[57:53] 11% increase to fees or to uh the health insurance costs.

[57:59] » Okay. So then going down the line to our other items. Um Yep.

[58:07] » Before we continue on, >> explain to me under salaries it shows

[58:14] 400,86. Yes.

[58:17] » For your staff. >> Yes.

[58:18] » And then I go to the last page. >> Yes.

[58:22] » For the subtotal for all of those wages. And it shows

[58:27] » $599,882.

[58:31] So explain that to me. Absolutely. >> To the group so we understand the team.

[58:35] » Okay. So because our rehab programming is

[58:41] required to stay in a fund 11 type situation which means a rollover

[58:46] account. It means whatever money we utilize or collect in the offering of

[58:52] those programs has to stay in that program. All of the expenses and

[58:57] revenues are accounted for in a fund 11 account.

[59:03] So when you are looking at the breakdown on page three of all of our staff

[59:09] people, it is looking at every staff person whether they are in the public

[59:14] health budget or the rehab budget. When you are looking at these numbers,

[59:20] this is only the public health budget. Rehaw is accounted for in our fund 11

[59:26] accounts. So when you look down here at REI, you can see our revenues and you

[59:33] can see the summary of expenses and so all of the the salaries,

[59:39] personnel, um mileage, all of that is all accounted

[59:44] for in those line items. I have a very detailed rehab budget um that we utilize

[59:51] to to come up with these numbers. But um as far as the overall

[59:59] health department budget, it's supposed to be money in, money out. That's how we

[1:00:03] are supposed to be budgeting for that program. So that is why it's in a fund

[1:00:08] 11 and that's why it looks a little bit different when you're looking at the

[1:00:12] personnel um section of the public health budget versus the itemized list

[1:00:17] of staff people. Does that make sense? There are three staff people whose um

[1:00:23] expenses are all covered under REIHA and so that is where they are accounted for

[1:00:27] in our budget is in that fund 11 account.

[1:00:31] » You lost me on where where it is accounted for. I see

[1:00:38] » on rehab the income on page two. I don't see the expense. Is

[1:00:45] that the 306? >> Maybe just go back. Yep. Right there. Um

[1:00:48] above it. right here under her expense. >> Yeah. So the expenses and the revenues

[1:00:56] are budgeted as equal because that is how the the program is intended to be

[1:01:02] operated. Um but then these numbers come from the

[1:01:12] rehab budget which we have board of health approve in um February Marchish.

[1:01:20] Is there a better way to break this out than to do it like this? Because this I

[1:01:26] mean when when you first look at it you go 400,000

[1:01:31] 401 and then you go to the end and you see 600,000.

[1:01:38] » Yeah. >> Is there a better way to do this so that

[1:01:41] we can see that you're pretty much talking two different programs?

[1:01:47] » I mean Stacy and I have talked about this. I you know we can modify if we

[1:01:52] have to. I can find that. So, I'll just not to interrupt you, Jamie, but I can

[1:01:56] add more lines to her budget here. >> It's going to obviously make hers more

[1:02:01] than three pages, but you're literally just going to see

[1:02:06] um rural environmental health salaries and then all the benefits and then

[1:02:11] you're just going to have one other single line with all the other stuff.

[1:02:15] » I certainly can do that if you want, but >> yeah. Um, I was going to suggest that

[1:02:20] maybe on page three that um, yes, these are the department totals, but then

[1:02:27] maybe you could have lines how much of it's going up above.

[1:02:31] » So, would you rather >> top and then another line that shows how

[1:02:35] much of it is a portion of that 306831. So you you could have notate there's

[1:02:42] room on page three for some additional notations and and so on and that might

[1:02:47] take care of it. >> So I guess then I I would recommend that

[1:02:51] we I'll pull out those three Oh, go back Jamie.

[1:02:54] » Sorry. I'll pull out those three positions as its own section and then

[1:02:57] it'll have her board of health as a section and then we'll have the total

[1:03:01] and then at the top if you scroll up Jamie

[1:03:05] » where we have her single line um I'll just kind of break it out and just if

[1:03:10] you don't mind so it's not a bazillion pages longer. I could just do salaries

[1:03:14] and benefits as one line and then break out so you can see what the additional

[1:03:18] costs are for the rest of the program. Does that work?

[1:03:22] That was kind of my thought the way I was reading an eye.

[1:03:25] » And at any given >> I think as long as we could compare

[1:03:28] between the two that would help. >> Okay.

[1:03:30] » It would work then if we had that on page three separately.

[1:03:35] » And at any given time if you are wanting to see the the very detailed breakdown

[1:03:40] of how REIA is budgeted for, we can always do that. Just know that they're

[1:03:45] not going to be apples to apples because RIHA is a fiscal year. This is a

[1:03:51] calendar year, so we're kind of trying to average two budgets to come up with

[1:03:54] this number. But um but they are always available. It's just that we passed that

[1:04:00] already in in February, March. So yeah, but I yeah, if if it helps to break it

[1:04:05] down, Stacy and I have gone back and forth on this. How do we make it simple,

[1:04:09] but then how do we make sure that it's available and easy to read? And yeah,

[1:04:13] your um your suggestions. I mean, I think I think that'll help with

[1:04:19] splitting it down a little bit more specifically.

[1:04:24] Okay. But yes, thank you. Thank you for

[1:04:28] bringing that up because they're they're truly it

[1:04:32] the personnel sections are accounted for in two different areas which is a little

[1:04:37] bit unique in terms of county budgets. So,

[1:04:41] okay. So then moving on to our Do you guys want to talk about every section

[1:04:49] that didn't change or just the ones where we made some modifications?

[1:04:55] » Well, I had a couple questions. Uh, for example, purchase services.

[1:05:00] » Yeah. >> We're projecting a 26,000 expenditure

[1:05:03] this year. >> Yeah.

[1:05:04] » And we're reducing that to a 20,000 budget item for next year.

[1:05:09] » Yes. uh do we not plan on spending as much?

[1:05:13] What's what's the difference? >> Yeah. So, purchase services is it's kind

[1:05:18] of a catchall for whenever we receive grants and they require us to contract

[1:05:24] out for something related to that grant. It goes in that line item. And so the

[1:05:30] 26,000 is because we had received a DOJ grant which required us to purchase

[1:05:35] billboards throughout the county. And so we had a contract then with layers and

[1:05:41] that's the line item that that came out of. Um

[1:05:46] unless we know we're going to have specific grants that raise those items,

[1:05:51] what I budget for are the things that I know we're going to do from year to

[1:05:54] year. So for instance, that $500 a year or sorry, $500 for the FET contract that

[1:06:00] comes out of purchase services. We know we're doing that. We budget for it and

[1:06:04] it's grant funded. Um, I'm trying to think. There are a number of other

[1:06:07] things that we just every year and we know we're doing it. So, we budget for

[1:06:10] that. >> So, your anticipation is there'll be

[1:06:12] less grants next year. >> My anticipation is that there's no way

[1:06:18] for us to know. We will always apply for them, but we do not always get them. So,

[1:06:24] I mean, we can we can always inflate revenues

[1:06:30] at the will of the board if you would like us to anticipate that we would

[1:06:35] receive grants. I my my personal preference is to go

[1:06:40] with what we know. Um, and some years were more successful than other years in

[1:06:46] getting grants. I know that we're in the process of applying for a few right now.

[1:06:49] If we get the immunization one that we're working on, it'll be an additional

[1:06:53] $35,000, which would be great, but it is very competitive. We didn't get it the

[1:06:57] last time we applied for it. >> So, um, you know, that's

[1:07:03] it will probably from year to year be a little bit higher than what I budget

[1:07:08] just because oftentimes our grants do pull from that line item if we're having

[1:07:12] to purchase something because of a grant. Um,

[1:07:16] » and a similar thought on office supplies.

[1:07:20] » Yes, >> we're projecting 7,000 for 2026. We've

[1:07:23] already spent 5,300. >> Yeah.

[1:07:26] » And we're dropping our budget back to 45.

[1:07:29] » Yes. Um, so here we had um while we were still trying to figure out our

[1:07:36] accounting for rehab, we were trying to figure out how do we

[1:07:40] expense items for that program? How do we make that work with a fund 11? How

[1:07:44] are we? We have also found that in some instances,

[1:07:49] we already have accounts as a public health department. It would be a big

[1:07:53] pain to have to create new accounts just for rehab. So, we'll spend it out of a

[1:07:59] line item that we already have. Instead of having to, you know, transfer money

[1:08:04] from this program to this line item to wherever, we just we'll do it within the

[1:08:09] line items that we have. So on what Stacy was talking about on editing page

[1:08:14] three >> y

[1:08:16] » uh or basically what rolls up to page two we would see a line for

[1:08:21] » salaries >> for personnel and a line for other

[1:08:25] » and then if there were any supplies etc etc that would be in the that would be

[1:08:30] in that rollup line. >> Yes in that other line. I mean, I can

[1:08:34] definitely break it out, but it's just not when we when she during the year as

[1:08:39] she's doing the program, we don't have like office supply line, postage,

[1:08:46] training, etc. because they make sure in their description when they're hitting

[1:08:50] that fun 11 account that they put training for Melissa or

[1:08:55] » right >> postage. So, like,

[1:08:57] » yeah, >> the details there. It's just not broke

[1:08:59] out in the budget, per se, >> right? If we see that there's 10,000 in

[1:09:03] expense there and we're over 2,000 here for supplies.

[1:09:08] » Y >> that's a good, you know,

[1:09:11] » however, if the numbers were reversed and we show 2,000

[1:09:16] » under RIHA and 10,000 up in supplies, then then we've got the issue health,

[1:09:24] not >> correct. Yeah,

[1:09:26] » I >> I don't need the to me I don't need the

[1:09:30] » line by line. >> Yeah.

[1:09:32] » Below >> and truly at any point because the um

[1:09:35] and I think we sent around the um schedule of vouchers. Um if there's

[1:09:41] anything that comes up, it's kind of just weird or unusual. Um I usually do

[1:09:45] bring it up. Um but yeah, we Melissa and I try to track that pretty closely.

[1:09:51] Every purchase that we make, which line item it goes in. Is this cell phones? Is

[1:09:56] this um office supplies? Is this mileage? Um it's just that yeah, this

[1:10:01] budget would be a very long budget if we had to do two separate ones. So

[1:10:05] » that's fine. Just so we can track. >> Yeah. Yeah. Absolutely. So I I think

[1:10:09] you've already answered this. One of the questions that I had was for travel

[1:10:14] under your health department expenses and that my question was going to be

[1:10:19] will that cover because we have more staff, we have Green Lake, we have

[1:10:24] Marquette, different employees from different areas, there will be a lot

[1:10:28] more travel, but you've got that included over in this budget. Yes.

[1:10:33] because over here your travel decreased but yet um we're going to have more

[1:10:39] travel because of re So that's that question got answered for me. Um

[1:10:45] » yeah, the line bylines that you get here are the public health budget. The rehal

[1:10:49] line items are the ones that we all approved in February.

[1:10:52] » And also environmental health, which is under the health department expenses,

[1:10:58] that's $23,000. Yes. So environmental health is separate

[1:11:03] from rehab. >> It is.

[1:11:06] » Okay. >> Yes. And let me explain that to the

[1:11:08] group too. So for as long as we have had an environmental health consortium um we

[1:11:15] have had to pay a portion of tax levy to to have those services because there are

[1:11:21] portions of environmental health that are unfunded mandates. And so we have

[1:11:26] always paid whether it was washer county or put that money towards our own

[1:11:31] programming, we have always had a line item where we are accounting for the

[1:11:36] environmental health complaints and tracking and all of that enforcement

[1:11:40] side of it. So when you're looking at the public health budget, the

[1:11:46] environmental health line item is our portion. It's the Marquette County

[1:11:51] portion to pay for the unfunded mandates of the environmental health program. Um,

[1:11:57] this line item hasn't changed a whole lot over the years. I did put an

[1:12:02] anticipated increase of about $500 for next year just to keep up with

[1:12:05] inflation, but um that is something that like I said, we have had to chip in as

[1:12:12] long as we've had these programs because there are un unfunded portions of the

[1:12:17] rehab program. And again, when we when we go through and do our rehab budget,

[1:12:23] that is a section when we talk about the funding for environmental health

[1:12:27] complaints that is listed specifically. There is a line item where it comes from

[1:12:31] us, Marquette County, as well as from Green Lake County. They cover their

[1:12:34] portion as well. John,

[1:12:38] » yeah, if you could go back to that example of office supplies and

[1:12:46] » Yes. >> So, yeah, that's that's right. Um,

[1:12:50] so $7,000 expected expense, 4500 budget. Where does that difference of that 7,000

[1:12:58] where does that end up in the environmental health program is does it

[1:13:03] show where that ends up? So what had happened here is again when we when we

[1:13:08] first started Reha up there was there was an amount of infrastructure supplies

[1:13:13] that we needed to purchase right and as time goes on that's pretty minimal from

[1:13:18] year to year right it's not that expensive to replace paper clips but

[1:13:21] when you have to get paper paper paper clips uh laptops laptop bags all the

[1:13:25] supplies they need for um for the program for three new staff people

[1:13:31] we didn't quite have a sense of how we were going to

[1:13:36] account for rehab being separate within this budget.

[1:13:41] » So those initial purchases, a lot of them were put under office supplies

[1:13:45] because we had to make the purchases and they had to go somewhere. It was the

[1:13:49] most logical place. Now what we did then is once we determined, you know what,

[1:13:54] this has to be a fund 11 account. Now we have account numbers, we work with Stacy

[1:13:58] to make sure that we, you know, situated our accounting practices. Then REIHA

[1:14:04] will the REIHA account will reimburse the public health account

[1:14:08] » and is that shown somewhere here? >> I mean not a specific line item. No, but

[1:14:14] it would show up in um uh revenues health department revenue and it would

[1:14:19] show up as a rehaw expense. >> Okay, I get it.

[1:14:23] » So So yeah, in the beginning we had to kind

[1:14:27] of finagle things around while we were trying to figure out the best way to do

[1:14:30] the accounting. So, health department revenue then that

[1:14:34] line item that we were just looking at. Yep.

[1:14:36] » That would include some inter account transfers,

[1:14:40] » interdep departmental transfers >> only that one time when she was starting

[1:14:44] the right the reh stuff. >> Yeah.

[1:14:46] » Now, going forward that health department revenue, correct me if I'm

[1:14:49] wrong, Jamie, is your um your other program.

[1:14:54] » Yeah. I want to say foot those are I think your top two. That's what goes

[1:14:59] into that health department revenue. >> Yes.

[1:15:02] » If it was a transfer between her funds, you would see a transfer line in there.

[1:15:09] » So that health department revenue is what you were talking about if some

[1:15:13] piece of equipment goes down that you have that money available for that.

[1:15:17] » Hang on here. >> No, that's this guy.

[1:15:22] » This one or this one? Right, Jamie? >> Property abatement.

[1:15:25] » It's equip. There we go. Here we go. Yep. health equipment revenue. This one

[1:15:28] right here, >> fund 11.

[1:15:30] » It's the fund 11 account. Yeah. So, that was the revenues. Now, where that comes

[1:15:34] from is we have our equipment loan closet. And so, when people, you know,

[1:15:38] they spend $5 to rent a walker. >> Yeah.

[1:15:41] » Every month, the money that we receive from that goes into the fund 11. And you

[1:15:45] can see up above what the balance is for that. Uh where's our equipment outlay?

[1:15:49] Here we go. >> This is This is your amount.

[1:15:53] » Sorry. I'm sorry. I don't want to make you jump. This is your amount that is

[1:15:57] spent each year through y >> through each. Now there's a piece that I

[1:16:02] don't necessarily show all the time, >> but there's a balance that is in down a

[1:16:08] little bit more. >> It's not on here, but here would be

[1:16:12] another section that would show her fund 11 and what her balances are at.

[1:16:17] » That's what I'm asking. when you said, "Well, you go over by that that month,

[1:16:24] » you know, the >> equipment revenue." Well, there $220 or

[1:16:30] $470. >> It adds up,

[1:16:33] » but how much is there really? >> There's in there. So

[1:16:40] she has

[1:16:43] projected to ending balance of for 123126 about $12,000 is sitting in there

[1:16:51] and that's about what she kind of carries over every

[1:16:54] » if you're looking at this it's under outlay. Where are we?

[1:17:00] » Health department project outlay. So it says 11,512

[1:17:04] in the um administration report that you have.

[1:17:07] » Yes. >> So yeah, we're able to keep track of

[1:17:09] that and we we spend very little out of it. But if a wheelchair breaks or we

[1:17:14] have to replace a tire or um we have to buy new um tennis balls to go on the

[1:17:19] bottoms of our walkers, like that's what comes out of. But then the idea is that

[1:17:23] if our cooler were to ever die, if we have a grant that we can strategically

[1:17:28] utilize, we'll do that. But if we don't, we have this balance that has has

[1:17:33] accumulated very slowly over time that would allow us to allow us to cover that

[1:17:39] cost. >> Yeah. Because when you talked about that

[1:17:41] initially, you said you had that that fund 11 and I wasn't seeing where that

[1:17:48] money was available or how much there was.

[1:17:50] » Yeah. >> Okay.

[1:17:51] » Yep. And they question >> do show up on the monthly reports. It

[1:17:56] just so happens it isn't on the actual budget for this. Yeah.

[1:18:01] » Okay. I got to figure out where we left off here.

[1:18:04] » I had a question also on travel. >> Yeah.

[1:18:07] » Uh we're at 1206, but I noted in the August

[1:18:16] detail of of expenses, we've got over 2,000 in travel reimbursement.

[1:18:22] So, >> so that'll bring us up to 3,200 plus is

[1:18:25] what we're talking about at 3500 enough to get us through the end of the year.

[1:18:30] » That is if you look that is under Jessica's expenses and Jessica's a rehab

[1:18:36] employee and so um those expenses will be attributed to the rehab budget and

[1:18:42] thankfully and the only reason that she got to go to this training was because

[1:18:45] it was a grant-f funed opportunity for her. So, um, but yeah, so that funding

[1:18:51] will come out of the reha expense account and then we'll be reimbursed by

[1:18:56] the grant which is the FDA program standards.

[1:19:00] » Okay. So, Kyle and Amber are also rehy and Amber and and their job is literally

[1:19:06] to drive around and do all these things. >> Kind of what I was figuring is okay and

[1:19:10] if we're doing 400 bucks a month for them,

[1:19:14] » yeah, >> we're not going to hit it with what

[1:19:16] we're budgeting. So, >> no, this this budget would definitely

[1:19:20] not be able to support the environmental health program, but this is the the EH

[1:19:25] program has a much a much healthier um budget for that reason because their

[1:19:31] job is to go to different facilities. So,

[1:19:34] » and would it make sense that we have a car? I hate to bring that up, but

[1:19:39] » we've we've talked about it. The problem is is that in order for them to get all

[1:19:45] of their work done, they should all be doing inspections most days.

[1:19:51] So, we would need three cars. And we have a staff person that's also

[1:19:55] stationed in Green Lake primarily to again cut down on mileage and whatever.

[1:19:59] But so, we'd have to have a vehicle stationed there.

[1:20:04] We've talked about it, but I don't I don't know that that's

[1:20:09] » I don't either. That's why I asked the question. So, as long as we're looking

[1:20:12] at it and keeping our eye on it, if I mean

[1:20:15] » expenses get to the point where we're looking at four 6,000 a year, it may be

[1:20:21] beneficial for us to have something, but >> I'd have to defer to our administrator

[1:20:25] here on whether that's a conversation to have.

[1:20:27] » I have a lead on a 1973 >> Pinto.

[1:20:31] » Awesome. >> Just don't, you know, sit in the back.

[1:20:35] But, >> Right. Right. I mean, we we can evaluate

[1:20:40] that in a more um intentional way if you would like us to. Um at this point, like

[1:20:46] if if we were able to work it such that all three of them were able to utilize

[1:20:51] one vehicle that actually you could probably make that work, but the way

[1:20:55] that their schedules are and to get it all done, they're pretty much all out

[1:20:59] and about every day. It would be hard to coordinate that

[1:21:02] » and I I get that. But when I'm looking at travel and 3500 a year, I was like,

[1:21:07] well, we're running those expenses monthly.

[1:21:10] » It's not going to work. But so the bulk of those are rehab. So it's in a

[1:21:14] different spot. It'll reflect in what what Stacy's going to give us in total.

[1:21:20] » Yeah. >> But we could pull that up if we asked.

[1:21:24] And >> 100%

[1:21:25] » travel mileage and in that fund 11 would be X a year.

[1:21:30] » Yes. >> Gotcha. I'm good. And I was going to

[1:21:33] say, and if you'd like to after this, we can go through and do the rehab budget

[1:21:36] overview, too. >> Okay.

[1:21:40] » If Stacy and Ron are good with it, it works. I just want to understand it.

[1:21:44] » Yeah. Yeah. Abs. I know it's We tried to keep it simple by having them in two

[1:21:49] line items, but that makes it hard for you guys to pull apart and see which

[1:21:54] parts were what, right? >> Yeah. It took several meetings, Chuck,

[1:21:56] for me to even wrap my head around it with Jamie to sit down and figure just

[1:22:01] what we have here. >> And I I get it. And if you know, if I'm

[1:22:06] being redundant on questions, that's okay. But

[1:22:08] » yeah, that's fine. >> I'm trying to get there with you guys.

[1:22:12] » Yeah, I was going to say it's it's a beautifully color-coded um spreadsheet

[1:22:17] if you're ever looking for something to do on an afternoon. We'll go through it

[1:22:21] together.

[1:22:24] Are you bringing popcorn? >> You know what? If if you're coming, I

[1:22:29] will I will bring popcorn. >> Awesome.

[1:22:31] » I'll even pick it up from downtown. Get you something fancy.

[1:22:34] » It's an expense. >> Yeah.

[1:22:36] » Yeah, that's quite the expense, but okay.

[1:22:38] » It would be a special meeting. >> Okay. All right. So, um, anything else

[1:22:46] before we start getting to where the changes are in line items? I had a

[1:22:49] question on revenues if you are ready for revenue discussion.

[1:22:54] » Well, I was going to say let's let's go through the um the line items up here

[1:22:59] and then we'll get down to where our revenues are.

[1:23:02] » Perfect. >> Okay. So, for telephone, we had an

[1:23:05] increase of $500. That's just a trajectory based on what we've been

[1:23:08] seeing with the cost of our individual lines, cell phones, things like that. Um

[1:23:14] dues, we had a reduction of $250. That's because we dropped our Wisconsin Public

[1:23:19] Health Association fee. Um, we were finding that we weren't really going to

[1:23:26] enough of their trainings that being a part of the association was saving us

[1:23:31] any money. And Waldab is a a far more advantageous

[1:23:36] partner in terms of being in an association. They save us a lot of

[1:23:40] money, a lot of time. They offer us a lot of great resources. So, we

[1:23:44] maintained that one, got rid of the public health association one. That's

[1:23:48] the difference of 250. Um, and that's something that's happening across the

[1:23:52] state. That's not just Marquette County going rogue. It's uh there's a lot more

[1:23:57] value to us in Waldab. Um, in terms of travel, mileage, other

[1:24:03] and training, those were reduced by our budget team. However, um

[1:24:10] that, you know, based on trajectories, it does make sense. I don't see it being

[1:24:16] too terribly different from what we're looking at for the budget this year. The

[1:24:22] only reason that I had maintained the levels the way that I had for this

[1:24:25] coming year is because once those CO era grants go away,

[1:24:30] then the state starts passing those fees back along towards us. So instead of you

[1:24:35] know providing us stipens for trainings and whatever those things will go back

[1:24:39] to being full cost but I don't anticipate that happening this year. I

[1:24:43] had just sort of maintained it because it's easier to keep it in a budget than

[1:24:46] to try to get it back. But um but for 2027 that's probably pretty accurate. Um

[1:24:55] then looking at pharmaceutical and medical supplies things cost more but

[1:25:00] we're ordering fewer of them. So, for instance, our flu shots, um, we don't

[1:25:05] order nearly as many because we aren't providing as many. So, even though they

[1:25:10] cost more, we're not going to increase the expense side of that. Um, for

[1:25:16] equipment, that may be accurate, too. Um,

[1:25:20] you know, sometimes you have things that have to be replaced. Um, oftentimes

[1:25:23] that's, you know, laptops for new programs. We don't necessarily have

[1:25:28] anything upcoming where we would have to purchase it. At this point, we're on the

[1:25:31] rotation with MIS. So, um, again, pro probably accurate for 2027.

[1:25:37] Um, for TB and immunizations, we are, oh, sorry, I lied to you guys.

[1:25:44] The pharmaceutical and medical supplies, we are ordering fewer of some of those

[1:25:48] things and that is where that sort of washes out. But in TB and immunizations,

[1:25:53] um the reduction in the number of flu shots that we are given is reflected in

[1:25:59] that $5,000 decrease. And again, that's that's based on projections, based on

[1:26:04] what we've seen the last couple years. We're not buying as many. We're not

[1:26:08] giving as many. You know, why budget for the expense? And

[1:26:13] » just the what we're seeing there with the 20,000 in pharmaceutical medical of

[1:26:18] actual >> I assume there's an offset or a transfer

[1:26:22] that happens there. >> Yeah. So um like when you see here if

[1:26:25] we're looking at our 2026 budget how we anticipated that it would be about

[1:26:29] 20,000. So this is another one of those where we received a grant and we were

[1:26:33] able to purchase COVID and flu test kits. And so, you know, obviously we

[1:26:38] received the money. It comes into our revenue section, but you have to expense

[1:26:41] it out of somewhere. And we didn't know we were going to be getting that grant,

[1:26:45] so we didn't budget for it, but um when we made those purchases, they came out

[1:26:50] of that line item, which is why it's higher than it typically would be. But

[1:26:54] since that grant expires this month, >> it did last.

[1:26:57] » Yeah, I was going to say it's very soon, if not already. Um obviously, we're not

[1:27:01] going to have it next year. So, we didn't budget for that.

[1:27:05] And then for environmental health, again, this is the um the unfunded

[1:27:11] portion of our environmental health program, which we increased by about

[1:27:15] $500 just to keep up with um inflation. But in general, our um

[1:27:23] we've we've made a fairly significant reduction in the non-personnel expense

[1:27:28] side of public health. So, we were hoping you would forgive us the 500 for

[1:27:33] environmental Um, okay. So then coming into

[1:27:40] our fund 11s, I generally with the exception of rehab budget these all at

[1:27:45] zero because unfortunately when the spreadsheets get to them, it counts

[1:27:49] against what levy would look like. even though they don't get put back to levy

[1:27:54] if we, you know, say for instance make a bunch of money in the health

[1:28:01] equipment outlay that doesn't go to levy. So I just budgeted a zero so it

[1:28:07] doesn't affect our our overunder in the full budget. Um, in REIA when we budget

[1:28:12] for it, um, we make it same in, same out. Even though, you know, when we come

[1:28:18] in at the end of the year, it might be more likely

[1:28:22] came in under budget by $1,500, I still we're supposed to be budgeting for net

[1:28:28] zero. So, that is what I put into here. It's what I try for. Um, in terms of our

[1:28:34] state aids, I did keep them the same for this. Oh, wait.

[1:28:40] Yeah, I kept them the same for this year going into 2027. Um, we do still have a

[1:28:46] few of those lingering COVID era grants and um, we've tried to be really smart

[1:28:51] about expending these. A lot of our public health partners used them right

[1:28:57] away when they got them. Some of these grants we've had for now five years

[1:29:00] plus. We've really tried to say we're only going to spend $20,000 a year every

[1:29:06] year until this grant is gone. We're only going to spend 50,000 a year each

[1:29:10] year of this grant so that we could stretch it as long as possible. This

[1:29:15] 2027 is the last year of those grants. They all sunset after that point. That

[1:29:21] would bring us closer to a um estate aid revenue between 90,000 and $100,000 a

[1:29:27] year. That's about where our typical revolving program grants are sitting

[1:29:34] right now. Um, obviously again, we continue to apply for more

[1:29:38] opportunities. That's just I, you know, full disclosure to my board. That's what

[1:29:43] we're what we're looking at. Um, and I know we talked about this a little bit

[1:29:48] before, but in terms of the health department revenue, we are seeing

[1:29:53] decreases in the utilization of some services. However, with the increased

[1:29:58] revenue that we can collect by um by increasing the fees for our flu clinics,

[1:30:03] that should make up the difference in um the vaccinations that we're not giving.

[1:30:07] And again, that's a a net zero impact out of pocket for our consumers because

[1:30:13] this is billing the state funding programs, not um they're not out of

[1:30:17] pocket fees.

[1:30:21] » Did that answer your question, Chuck, or >> No.

[1:30:23] » Okay. But I like everything you said. >> Okay.

[1:30:27] » I was just looking at state aid for this year. We've only received through 6

[1:30:31] months 59,000. >> We're expecting to get 140. So we're

[1:30:37] under half. >> Um it and I was looking at human

[1:30:42] services budgets and I know their state aid kind of comes in more late than

[1:30:47] early. >> So I didn't know if yours was the same.

[1:30:51] Yeah. >> And that's why we're looking for 140 at

[1:30:55] this year because it's more of a timing issue than a steady monthby-month

[1:31:01] number. >> That's that's pretty typical. And a lot

[1:31:04] of what we find in and poor Melissa can can vouch for me on this. We get

[1:31:11] we have to wait until our contracts are fully executed before we can start

[1:31:14] billing on our grants. And unfortunately, sometimes we're waiting

[1:31:18] three, four, seven months for the contracts to be executed before. So

[1:31:23] there are some things where we're doing the program, we're tracking it, we're

[1:31:27] billing against the grant to the state, but they won't reimburse us until they

[1:31:31] send the contracts through. We just kind of have to wait. Once I get them, I'll

[1:31:35] get them read and signed, you know, within a couple days, but sometimes we

[1:31:39] have to wait a while for them those to come through as well.

[1:31:41] » So it's more of a timing thing. >> It's definitely a timing thing. probably

[1:31:45] have like three major grants right now where it's multiple months we're going

[1:31:49] to be we're waiting for pays. >> Okay.

[1:31:51] » Yeah. So it will show hopefully next month.

[1:31:57] » Just kind of stuck out to me. So >> absolutely. And and these are our June

[1:32:01] numbers. So So yeah, even >> even if we were to take a snapshot of

[1:32:06] right now, it would be obviously greater than what's in our projections here. So

[1:32:10] » great. Got it. >> Okay. So then um I guess rolling back to

[1:32:19] our sheet here, the um I guess just the overall

[1:32:24] budget um situation that we're in. Sorry guys. We will be we're expecting to

[1:32:32] return approximately $9,749 to the general fund. That is um

[1:32:39] partially because of some grants that we've been able to do. um

[1:32:44] you know we've been able to fund some people's time with the other thing we've

[1:32:47] been able to do is um I shouldn't say we've been able to do but we had some

[1:32:52] staff changes so there was a little bit of time in there where we weren't paying

[1:32:56] for as much salary so that accounts for most of that. Um we anticipate going

[1:33:02] into 2027 a net increase of about 11,789.

[1:33:11] Um but given the fact that the health insurance increases alone were over

[1:33:15] 15,000 um you know that's it's not worst case

[1:33:20] scenario but that was an increase of about $20,000 in personnel expenses and

[1:33:25] a decrease of 8,250 in non-personnel expenses. So that's that's where we

[1:33:32] equal out in the end.

[1:33:38] Okay. My question to you is, is this a realistic budget

[1:33:44] for your department? >> I mean, I

[1:33:49] it's always hard to know, but I mean, based based on projections, based on how

[1:33:54] things have been from year to year to year,

[1:33:58] I factoring out any potential grants. Like

[1:34:02] I said, we apply for them non-stop. You never know what you're going to get. I

[1:34:05] don't I don't think this is unreasonable. I really don't like I said

[1:34:09] the end the only part where um I called out that it that something may change in

[1:34:16] the future is in the section that the the budget team had made some

[1:34:20] adjustments on but I still think it would be fairly accurate for this year.

[1:34:24] it's just going into 28 29. Um if the state's not receiving those COVID era

[1:34:31] grants, they can't pass along those savings to us. And so we end up

[1:34:35] traveling more, paying for more trainings. Um you know, we'll do what we

[1:34:40] can to have them covered by grants where we can. Obviously, we try to be creative

[1:34:44] where we can be, but for 2027, I think that's

[1:34:48] because my position is, you know, I want a realistic budget. Number one, we've

[1:34:54] seen and it's gotten better over the years throughout the county that we've

[1:35:00] seen um overestimating expenses and underestimating revenue. And again, I

[1:35:08] Gary knows this going back to years ago when I would always say that when we

[1:35:13] would be at the um budget hearings that let's make them more realistic. And I

[1:35:20] understand you can't anticipate if you're going to get a $20,000 grant or

[1:35:26] but you have to go with trends and that's what I see here. And if it's

[1:35:32] realistic and it's attainable, I don't have an issue with it. If it's not

[1:35:37] realistic, then let's address what needs to be done. Whether there needs to be an

[1:35:42] increase or a decrease. And I know that's a terrible thing to say, an

[1:35:45] increase, but if it's realistic, I'm okay with it.

[1:35:51] » Yeah. I mean, certainly there are areas where we did increase our anticipated

[1:35:54] expenses based on projections. Um, like I said, I we we can't know about

[1:36:01] our grants, but barring that, this is

[1:36:07] I don't I don't think there's anything that's too too fluffed up or too

[1:36:11] deflated that it wouldn't be close to what we should expect.

[1:36:16] » The budget team that we did, aside from the changes that were made, we did agree

[1:36:21] that this was a good this budget's very hard to do compared to other because

[1:36:27] that five-year trend analysis that we had usually applied uh we're still

[1:36:32] factoring in some of this COVID stuff and public health all it takes is a

[1:36:37] crisis like Ebola or swine flu or something then all of a sudden you see a

[1:36:42] great interest the money flows in then it trickles out and sometimes doing this

[1:36:48] trend analysis is very difficult so I'm inclined to take you know year three and

[1:36:53] four of the co years and just throw them Are there outliers?

[1:36:58] » But that doesn't mean something else isn't going to happen.

[1:37:04] » Anything else from the committee? >> Well, and then I'll point out too that

[1:37:08] the health insurance that can really wobble a budget. It can flip-flop

[1:37:13] numbers very quick. All you need is one employee to leave who was on a family

[1:37:18] plan. The next employee comes in and their spouse works somewhere else that

[1:37:22] has great insurance. They don't take the county's insurance. And that department

[1:37:26] looks like a winner because their budget just went way down.

[1:37:32] » Meanwhile, the next department over hires a newbie and they take the family

[1:37:37] plan where maybe before they had a single person in that job and all of a

[1:37:41] sudden that one takes a big hit. So budgets can wobble big time with the

[1:37:46] health insurance. And it looks like yours wobbled a little bit. Something

[1:37:50] happened there that you jumped from 35 to 50. But um

[1:37:55] » one of your staff took one took the single didn't have it or

[1:38:00] » got married or something. >> But

[1:38:03] » u that's part of it and it and like I say some departments will come off

[1:38:08] looking great because they lose somebody that was on a family plan and the next

[1:38:13] one doesn't take it or takes a single plan. So

[1:38:16] » and that is a fair point. I guess I didn't consider that when I was talking

[1:38:19] to you about this, but um because obviously she works here this year. So

[1:38:24] to me that was already factored into our insurance situation. But yeah, this year

[1:38:30] we had a new employee start that took a single plan where that previous employee

[1:38:34] did not. Um so that that would factor

[1:38:39] » that explains a portion of the 50 plus >> portion of it. Yeah. Yeah. from what

[1:38:43] over what we had budgeted for 2026 because for 26 we didn't realize we'd

[1:38:47] have a different employee at that time. So yeah,

[1:38:51] that is true. But then the rest of it is that 11% increase. Just

[1:38:55] » the basic >> Yeah.

[1:38:58] Okay. Anything else from the committee?

[1:39:03] Thoughts, concerns, questions? Because the next step in this process is

[1:39:11] either approve or deny this proposed budget. And if we do um decide to make a

[1:39:19] motion to approve it, it would be moving forward with the executive finance

[1:39:24] committee. >> I would like to ask just one more

[1:39:28] question. Um I don't want to take too much time though since I might be the

[1:39:32] only one interested in this, but I would like to understand again going back to

[1:39:37] that um pharmaceutical medical supplies expense where it's budgeted at 3,700. We

[1:39:43] expect the uh total to be 20,000 from this year. There's going to be some kind

[1:39:48] of a transfer to bring that back to where it where we'd expect it to be. I'm

[1:39:53] just not seeing where that's coming from. What what other line item where

[1:39:58] would that come from? >> So where that where you'll see um the

[1:40:03] the difference made up is in that state aid area. And obviously it's not broken

[1:40:08] down by every single deposit that we make from state aid,

[1:40:13] » but um within pharmaceutical and medical supplies, we had that grant was 25

[1:40:19] 27,000 um and we were able to use a small

[1:40:23] amount of that to cover the time to administer the program, but otherwise it

[1:40:27] was truly purchasing COVID test kits and flu test kits. That was split over two

[1:40:32] years. So it was split in 2026. um and 2025.

[1:40:39] And so you're not seeing that full $25,000 reflected in our um in our

[1:40:46] projections just because we'd already spent a portion of it. But after we make

[1:40:51] that expense, we then build state and that funding would come in here in that

[1:40:56] state aid line. So that is accounted for in the

[1:41:03] um 140,000 that we're anticipating. >> Okay.

[1:41:13] » Thank you. >> John, you have something else?

[1:41:16] » That's all. >> Gary,

[1:41:18] » um I guess my only other question that I've asked different departments uh that

[1:41:22] I've gone to meetings, uh your full-time equivalency did not change. Is that

[1:41:26] correct on >> correct? Yeah, we um I mean the health

[1:41:30] department is >> Yeah, the overall

[1:41:32] » where we're at right now. >> Status qual.

[1:41:33] » Yep. As I say, we we had one staff person turn over, but in terms of the

[1:41:37] number of individuals we employ here, same.

[1:41:40] » Okay.

[1:41:46] » Okay. What's the wishes of the committee regarding the budget?

[1:41:56] Approve it. >> What's that?

[1:41:58] » I'll approve it. >> Okay. You are you making a motion to

[1:42:02] approve the current the proposed budget and um move it to executive finance?

[1:42:08] » Yes. >> There is a motion on the floor.

[1:42:13] Is there a second? >> I'll second it.

[1:42:15] » Okay. There's a motion and a second. Any further discussion?

[1:42:21] Anybody?

[1:42:24] All right. All in favor say I. >> I.

[1:42:26] » I. >> Opposed.

[1:42:29] » Motion carries. >> All right. Next item

[1:42:35] on the agenda is the introduction to the county health rankings.

[1:42:42] So, I think the county health rankings are a really cool thing and I was hoping

[1:42:47] to be able to spend a little bit of time on this. That was probably wishful

[1:42:50] thinking, but it is fairly user friendly. And so, um, I think I'm just

[1:42:57] going to show you what it is and show you a little bit of how you can maneuver

[1:43:01] in it. And if you ever find yourself with a couple extra minutes and you want

[1:43:04] to poke around and see what's going on in Marquette County, um, then please do.

[1:43:10] Um, but I just I felt that this was important to talk about because when you

[1:43:15] look at the mandates of public health, there's so much about assessment,

[1:43:19] surveillance, tracking, monitoring, and the work that we do is generally

[1:43:24] speaking required to have an evidence base, right? We have to be able to show

[1:43:27] that there's a true need that's measurable. We have to be able to show

[1:43:30] that there are outcomes that are measurable. And one of the tools that we

[1:43:35] utilize to measure that is a a website that's called the county health rankings

[1:43:40] and road mapaps. And so if you were to go to Google and just type in county

[1:43:46] health rankings, you will get this website here.

[1:43:50] And what you're going to want to do is scroll down a little ways and say find

[1:43:54] data by location.

[1:43:59] And um you can you can search by state, county, or zip code. However, I tend to

[1:44:04] just type in Marquette. You have to be careful. They do include Michigan. This

[1:44:09] is a nationwide um tool, so everybody's in it. Um and the cool thing about this

[1:44:18] is that they show what's going on in Marquette County. They show what's been

[1:44:22] going on in Marquette County over the years. So you can see you can look back

[1:44:27] at reports back to 2011. Now they will say and there are disclaimers if you

[1:44:34] look in the data it will say these are not apples to apples. Sometimes the

[1:44:38] tools that they're using to measure these things become more robust. They

[1:44:42] become um you know they might start looking at different types of data but

[1:44:49] it still gives you a fairly decent picture of how things are changing in

[1:44:52] your area. I'm going to stick with with uh 2025 for right now. But then they

[1:44:58] give you sort of an overview. You can see Marquette County is considered

[1:45:00] rural. We are 100% rural in Marquette County. We have a low population

[1:45:05] density. And then they give you snapshots of where the population is and

[1:45:12] how healthy we are. Now you can click oftentimes there will be a little chart

[1:45:17] that shows you what the trends are. So you can see how we've improved or

[1:45:21] declined over time. You can see how we compare to the healthiest and least

[1:45:26] healthy communities in the nation. And then you can go through and you can

[1:45:32] look at how we rank in these different areas. So you can see length of life um

[1:45:40] and other different factors that impact how healthy a community is. Things like

[1:45:45] low birth weights or poor mental health days.

[1:45:49] You can also look at community conditions

[1:45:53] and um these include how many people are

[1:45:59] getting flu vaccinations. Um how many dentists are there? How many doctors are

[1:46:04] there? Are there shortage areas for these providers that help keep people

[1:46:08] healthy? Again, if you were to ever click on any of these, you could see

[1:46:12] like we'll just click on one for instance.

[1:46:15] You can see how we compare to Wisconsin, the United States, and our own selves

[1:46:21] over time.

[1:46:27] And then there are many other factors that you can look at, even like access

[1:46:30] to a library, which most people don't innately think about as a health factor.

[1:46:35] However, an educated community is often a healthier community. and having access

[1:46:40] to libraries even if you don't have the money to purchase books and services can

[1:46:44] go a long way in making sure that people continue to have healthy.

[1:46:48] So this is really cool that you can go

[1:46:51] through and you can say hey what's Marquette County doing? How do we

[1:46:54] compare to others? What's really fun is you can also say well how do I how do we

[1:46:58] compare to other people? And you can say, I'm going to select another

[1:47:04] community.

[1:47:08] We'll just say Adams County because they're next door.

[1:47:15] We're really not gonna

[1:47:19] certainly Adams County is not in Wisconsin. Scroll down.

[1:47:23] » You got to scroll down. >> Okay. I was gonna say I'm like, why am I

[1:47:25] not see? Okay, here we go. Thank you guys. I'm sorry.

[1:47:28] » All right. But you can you can actually have up to four counties side by side

[1:47:33] and compare. Well, how how are we compared to Adams County? It looks like

[1:47:39] in terms of years of potential life lost, Marquette County may actually be a

[1:47:44] little bit above our neighbors. So, you can you can do this for any county in

[1:47:48] the nation. If you wanted just to compare how the Marquette counties of

[1:47:53] the nation are doing, you can put them side by side. If you want to look at our

[1:47:57] neighbors, if you want to look at how we compare to an urban versus a rural

[1:48:01] community, you can do that. Um, now again, obviously I'm not going to go

[1:48:05] through and look at each of these different factors and talk about them.

[1:48:09] But when we are looking at potentially either adding programming or when we're

[1:48:15] doing our community health needs assessment, which is a mandate for

[1:48:18] public health, we are looking at this data. So, one of the reasons that we

[1:48:24] continue to host a foot clinic here in Marquette County, first because it

[1:48:28] covers itself in terms of cost, right? So, it meets our criteria match in terms

[1:48:33] of our programs and being allowed to have them. But when we look at the data

[1:48:36] for Marquette County, we see that slips, trips, and falls are one of the number

[1:48:40] one causes of um unintentional or um early death in our communities. And in

[1:48:47] Market County, we're actually close to number one in terms of unintentional

[1:48:52] slips, trips, falls, and then the health consequences of those. And so when we

[1:48:58] look at those numbers and we say, "Hey, we've got this program that doesn't cost

[1:49:02] taxpayers anything. It provides a valuable service and it makes it so that

[1:49:06] our our seniors can be healthier for longer in our communities or just people

[1:49:10] in general can take better care of their feet and be more mobile and be healthier

[1:49:14] longer. that's an opportunity that we're going to take advantage of, but we have

[1:49:18] to be able to show that it's something that's worthwhile and you know,

[1:49:23] statistically it matters in this community. Um, at one time we were

[1:49:27] spending a lot of time and effort partnering with um,

[1:49:32] oh my gosh, Marshfield Clinics to bring in mobile mimography. And one of the

[1:49:37] reasons that we were able to prove that we could utilize that partnership here

[1:49:41] in Market County is that we had really low levels of mimography screening. This

[1:49:47] has improved in the last several years. When we first started that program or

[1:49:51] attempted to have that partnership, Marquette County was in like the 20%

[1:49:56] range. Um, so then you could see, you know, how we compare to Oh, they're

[1:50:04] just doing Adams County now. They're not going to show the whole nationwide, but

[1:50:07] we were like 50% of if the nationwide average was 80% of

[1:50:14] individuals were having this annual screening done, Marquette County was

[1:50:17] half of that. We were just we were not doing great. But we could justify it. We

[1:50:21] could have those conversations with our partners and say, "This is a true and

[1:50:24] legitimate need. Here's how we can prove it." Um, so again, I'm not going to go

[1:50:30] line by line, but it is a really cool website to poke around in. You can add

[1:50:34] any county in the nation. Um, but just know that it is one of the many tools

[1:50:38] that we utilize in Marquette County to justify our programs or efforts and then

[1:50:43] also just to assess where we're at in terms of health.

[1:50:48] Does anybody have any questions? >> Um, I guess I do. Um,

[1:50:54] how about because I've had people come up to me. They're not from Marquette.

[1:51:00] they're from with >> Sherah,

[1:51:02] » but um there's been an increase in cancer deaths among younger people and

[1:51:10] then how that environmentally is. So cancer screenings I would think would be

[1:51:18] » yeah they've changed what's available for some of these.

[1:51:21] » Right. So, but when you said mamography, I'm thinking and this is

[1:51:25] » yeah, >> there's been an uptick of multiple

[1:51:27] myyoma in that area and it's concerning if if you um put statistical

[1:51:34] information together as far as environmental and how

[1:51:38] » these are people in their 50s and 60s and so it's very concerning,

[1:51:43] » right? >> There's been six deaths in the last four

[1:51:45] or five years. >> Yeah. and they um I will say kind of

[1:51:50] » and because it's a rare cancer that's what's concerning about it,

[1:51:53] » right? It's why it stands out so much, >> right? So I'm like so because they're

[1:51:57] close to us, I'm wondering if that kind of information is you're not going to

[1:52:03] find that in the county health rankings. I just went to to do a quick scroll

[1:52:07] here. Um it is generally not broken down that closely. Now, if we're looking for

[1:52:14] something like that, vital records would probably be where we would look for that

[1:52:19] data. Um, the WISH data, which is Wisconsin statistical health data, is I

[1:52:27] think what that stands for. Um, that would allow you to look more at

[1:52:31] diagnosis, cause of death. Um, obviously, as a public health

[1:52:36] department, we have access to vital records. It is a confidential database,

[1:52:39] but we're only able to see within Market County. So, I couldn't look it up and

[1:52:43] say, "Well, how do we compare nationwide or how do we compare to our neighbors

[1:52:47] or, you know, even down south versus northern states?" Um, but when you're

[1:52:54] talking about screenings, that's where public health could benefit because a

[1:52:57] lot of these people are are not getting screened and there's a lot of cancer

[1:53:02] screenings you can do. I mean, not just public health, but educate people to

[1:53:08] do. >> Yeah. to seek their primary care and

[1:53:12] establish >> that they're not

[1:53:14] » they're not educated on. >> So

[1:53:20] » yeah, absolutely. And um I'm sure you are all well aware that we are a health

[1:53:25] provider shortage area in Marquette County. Um the majority of people who

[1:53:30] well most people should go to the doctor at least once in a while, right? Most

[1:53:35] people should have a primary care provider, but the majority of people in

[1:53:39] Marquette County are having to leave Marquette County to establish that care,

[1:53:42] which you know, if you have any sort of transportation issues, if you have a

[1:53:47] busy schedule and it's just hard to get away, you're driving further to obtain

[1:53:51] it. Um, and we actually just had Crossroads Clinic close in market for me

[1:53:56] as well. So, um, you know, we we didn't have very many clinics to begin with and

[1:54:02] so that certainly doesn't help our situation.

[1:54:05] » But, um, yeah, certainly public health, we're always

[1:54:08] » advocating for whether it's cancer screenings, health screenings, just

[1:54:12] primary care, having a medical home. >> Yeah. And even sometimes when you do

[1:54:18] have all of those things in place, sometimes cancer can be a tricky thing

[1:54:21] to >> Yeah.

[1:54:22] » to find. So, no, I agree with you. This is not going to nail down something so

[1:54:28] very specific and rare as a type of cancer. But

[1:54:32] » I guess a lot of people just don't know even if they go to their doctor what to

[1:54:37] ask for at certain ages. A screening just cancer screening. There's certain

[1:54:43] » certain things to ask and

[1:54:47] » absolutely. Okay. I just I just wanted to show you

[1:54:51] guys that and this is this is available publicly. All you need is an internet

[1:54:54] connection and and you can poke around and um there's a bunch of other

[1:55:00] information in here and if you're ever looking at not maybe that you guys

[1:55:04] specifically would, but if we're ever um being encouraged to attempt a certain

[1:55:09] kind of program to make sure that we're addressing a certain health problem,

[1:55:13] they do often have evidence-based suggestions for programs on how can you

[1:55:20] roll something out in such a way that you would have an actual noticeable

[1:55:24] impact. So they have promising practice evidence-based programs and

[1:55:29] I mean obviously you still have to put in the work, you still have have the

[1:55:32] capacity and the funding, but oftentimes there are templates you can follow if um

[1:55:37] if there's something in particular that you're wanting to uh you know roll out

[1:55:41] or work on. Okay, that's all I had for that.

[1:55:47] » Okay, old business the reception update. Yes. And this um this was requested at

[1:55:54] our last board of health meeting. So um I figured I would just

[1:56:00] bring it up again for you. Um this is for for those of you who may not um

[1:56:08] remember we have been updating about this semi-regularly.

[1:56:13] We have been providing the um reception services for human services for I guess

[1:56:20] the last couple years. Time flies when you're having fun. Um but we we have to

[1:56:26] track how we utilize our time. We track them for our grants. We track them for

[1:56:31] um accountability purposes. And when we are serving specifically clients that

[1:56:37] are not utilizing anything in public health, then we track that time

[1:56:41] separately. And you can see that obviously we have some months where it's

[1:56:45] a little bit higher, some where it's a little bit lower. Obviously open

[1:56:48] enrollment months seem to be a little bit busier. Um but we are pretty well

[1:56:53] averaging um 45 hours a month

[1:56:59] and that's I mean if you look at that curve that that's pretty consistent.

[1:57:04] Obviously, in the beginning, we were utilizing or spending a lot more time at

[1:57:07] it, but we were also still learning and trying to figure out how to, you know,

[1:57:12] engage the public as it related to some of those programs. Um,

[1:57:18] I don't I don't know if there was anything in particular we needed to

[1:57:21] tease out for anyone, but since it is something that we're doing, we wanted to

[1:57:25] make sure that we're accountable to you and you know how it is that we're

[1:57:28] spending our time.

[1:57:32] the 40 hours a month on average. >> Does that impact any of our grant

[1:57:38] application status? Either makes it better because we're doing it for human

[1:57:42] services or it would be detrimental because we're spending this time on

[1:57:49] different department, different program. I mean it's it's certainly FTE that we

[1:57:55] are not able to utilize in public health but I wouldn't I wouldn't call it a

[1:58:00] detriment to to grant funding um because whenever we apply for something we have

[1:58:07] to show that we have whatever it whatever it is that they require for you

[1:58:12] to um for you to manage the program. So, um, and generally speaking, I mean, poor

[1:58:19] Melissa, some grants are a lot bigger of a pain in the butt to track than other

[1:58:23] ones. Um, so obviously she's a little bit more busy because she's doing a lot

[1:58:28] of that tracking of some of those grant programs. But when it comes to like if

[1:58:33] we get a grant to do more reproductive health programming, that's generally

[1:58:38] going to be the nurses that are doing that programming. or if it's

[1:58:41] immunizations, our public health tech and our nurses would be doing more of

[1:58:45] that. And then Melissa just she's going to be doing a lot more grant tracking

[1:58:50] and time tracking related to it, but the reporting end maybe takes a little

[1:58:54] longer because that's what I'm working on and that gets interrupted when people

[1:59:00] come in. it still gets done um and it doesn't defer us from getting any money.

[1:59:06] But that is the my end of it is the reporting

[1:59:11] » because I also look at it is when you're doing the reception you're dealing with

[1:59:16] all the different aspects of the human services department whether it's you

[1:59:22] know ADRC or you know family you know services whatever it is. So, I'm just

[1:59:29] wondering if they can get some funding to help offset your time then some type

[1:59:37] of grants or something to offset. I'm just looking at we're using 40 hours of

[1:59:44] this time to do another program and I understand the cooperation and all that

[1:59:50] with the other departments, but is there something that we can gain or are we

[1:59:56] losing anything? Can you explain that portion?

[1:59:59] » Yeah. Indirect cost reimbursement is um we still have Maximus,

[2:00:06] I believe, for that. Do they pick it up? >> You're talking about inind hours.

[2:00:11] » Yep. >> Yeah, that could qualify, but you'd have

[2:00:13] to coordinate it with Mandy to see what could potentially

[2:00:17] » Mandy and Jennifer might be able to work that in through that special auditor

[2:00:22] that comes around for indirect cost reimbursement from the feds.

[2:00:26] Yeah. And most of Mandy's uh grant programs, even if they're mandated and

[2:00:31] we have a funding source, do have a match of some kind applied to it. So,

[2:00:38] » just something to think about. I can check in with her for sure. Yeah. I I

[2:00:43] don't know. As much as I'd like to say we rely heavily on state

[2:00:48] grants, but we don't get near the state grants and federal grants that they do.

[2:00:52] Right. But so as much as it's both our worlds, I think the the reimbursement

[2:00:57] that they're able to obtain, they have completely different mechanisms than we

[2:01:01] do for some of these. Like when it comes to indirect costs,

[2:01:05] sometimes we're allowed to ask for them if we are. It's like $500. It's not, you

[2:01:09] know, we don't have as many of those options available to us. So I can I can

[2:01:13] always check with Mandy and see if there's an opportunity there.

[2:01:20] Anything else on the reception update? >> No.

[2:01:25] » Okay. Budgets, the report from administration, it was

[2:01:30] passed around. >> Yep. And those are the same numbers that

[2:01:35] um were featured in the budget that we presented to you today. So, um our

[2:01:42] projections and six month costs are all on that document. Um,

[2:01:49] again, we're projected to come in a little bit under budget, primarily due

[2:01:53] to staff changes. We're on track for where we would expect to be about this

[2:01:56] time of year. So, any questions by the board?

[2:02:01] Okay. And the vouchers, everyone had a chance to take a look at those and are

[2:02:07] there any questions? The one big thing I wanted to point out

[2:02:11] to you guys is that there is one fairly large expense in there that might seem a

[2:02:18] little bit strange initially. Um, Jess had mentioned it also, but um, we owe

[2:02:24] GAP a percentage of the license fees that we collect for the the privilege of

[2:02:29] of hosting the service. And so that came out to the tune of 18,600

[2:02:36] and something. But that reimbursement is accounted for in our schedule of

[2:02:40] vouchers this this past month. So that's a rather large expense that wouldn't be

[2:02:45] typical in a in a regular month. So I just want to parse that out so you know

[2:02:49] what we're looking at. But but otherwise it's

[2:02:54] mostly typical expenses. The only other place where you might see an outlier is

[2:03:00] um in Jess's reimbursement, but again that's primarily due to travel. So

[2:03:05] that's plane tickets. Um I'm trying to think expenses related to

[2:03:10] having meals, being out of town for 5 days. So

[2:03:15] those are the big the big outliers there.

[2:03:19] Any questions from anyone on the vouchers?

[2:03:24] Okay. Um any upcoming events or issues? >> Where are we at with the 140 review

[2:03:29] results? >> Well, they said that it could take up to

[2:03:33] six weeks. Okay. >> So, but they said if you don't hear from

[2:03:37] us. You can reach out if you would like. Just know we have not forgotten about

[2:03:41] you. It could take a couple months. So, >> yeah.

[2:03:45] » I thought you did really well. >> Yeah. Team did really well. It um I

[2:03:50] suppose yeah, that could be just an FYI for you guys. Um we are required to do a

[2:03:55] statutory audit every five years with the state. That was in August of this

[2:04:01] year. They had four people come from Wisconsin DHS and they come and they

[2:04:06] make sure that we're meeting all of our statutory mandates and they're auditing

[2:04:09] us on that. Um they it could just be done with myself

[2:04:15] in the state. However, um they really do like it when you're able to engage the

[2:04:20] whole team because as much as I can explain programs, I'm not the one that's

[2:04:24] doing all of them and they don't want to hear me talk the whole time. So, um but

[2:04:29] it went really well. Um, everybody pitched in to explain their portions of

[2:04:34] their roles and they did a really great job explaining to the state how it is

[2:04:37] that we're meeting all of these requirements. And so I'm I'm sure

[2:04:40] they'll come back with some recommendations because that's that's

[2:04:44] how things go. But overall, I thought it went really well.

[2:04:48] » Yeah. And then yeah, we'll get the report

[2:04:52] probably what is the date now? Hopefully within the month. And then um generally

[2:04:58] speaking they will do a presentation of um 140 certification at board of health.

[2:05:05] So at some point the state will come and they will present the certificate to

[2:05:10] Judy as our chair to show that we've we've met

[2:05:15] the the minimum compliance requirements for a public health department at a

[2:05:20] level two status and we are a level two health department. So that's what we

[2:05:23] were being measured against. So, >> okay. Anything else?

[2:05:31] All right. The agenda been completed. The meeting is adjourned.

[2:05:36] » Thank you guys. I know that was a

Board of Health 09/08/2026

Transcript