[This transcript was generated automatically from audio using AI and hasn't been reviewed by a person -- it can contain mistakes, including plausible-sounding sentences that were never actually said. Treat it as a starting point, not a verbatim record.]

[0:03] All right, we are at 530, so I will call the meeting to order.
[0:12] First up, we have members present, we have myself. Ron Johnson is here, Don Trook, Renee Lyon, Scott Leonard, Scott Brown is online, Dr. Brightenbach.
[0:27] I, she, let me know that she's not going to be here.
[0:29] Okay, thank you.
[0:30] Thank you.
[0:32] And Dr. Baxa, and carried on, said, thank you.
[0:36] All right.
[0:38] Then we have certification of open meeting laws, Matt.
[0:42] Okay.
[0:43] And first up, we have a public comment period.
[0:45] Members of the public will have a 15 minute block of time
[0:48] to comment on today's agenda items.
[0:51] Members of the public may be present in person,
[0:54] or call in to make such comments to comment.
[0:56] by telephone, please call 7-1-5-5-3-8-1-8-9-4.
[1:03] Public comment may be extended or curtailed that the discretion of the presiding committee board chair or vice chair if the chair is unavailable.
[1:10] And after advisement by the committee board.
[1:14] All right.
[1:16] Then we have the adoption of the agenda.
[1:19] Everybody has the agenda, I'm assuming.
[1:22] Second.
[1:25] Motion by Ron, seconded by Don, was it Don?
[1:29] To approve the agenda, and favor say aye.
[1:33] Those opposed same sign.
[1:36] Then you also have a new packet, the minutes from August 10th for approval.
[1:42] I would move to approve those minutes.
[1:46] I'll second. Motion by Renee seconded by Dawn to approve the August 10th Health and Human Services meeting all in favor say aye.
[1:55] All right. Those opposed the same sign.
[1:59] All right. Next item of business is our program spotlight the community support program.
[2:06] Jamie Kurtz. Hello. I'm here with the community support program team or CSP program.
[2:16] For the county and I will let them take it over. They did print out some brochures for
[2:23] everyone so they'll be handing those out and sorry they're kind of, that's kind of my fault.
[2:29] You have to like flip it over and print it right.
[2:34] But I'll let them take it over and they'll
[2:36] talk about what they do, maybe each position does, and then what the program does, and we'll
[2:45] go from there. I don't know if Lisa wants to start the RN registered nurse of our program?
[2:58] Yeah, so, on Lisa, I'm the CSB nurse, then we have Jessica, she's the social worker, and
[3:08] a little bit about the community support program. It's designated to meet the needs of our chronic
[3:16] and persistent mentally ill clients in our community.
[3:22] We have clients that all different, you know,
[3:24] ages 18 to, oh, sorry, sorry, sorry, from, you know, 18 all the way up to elder,
[3:35] our elderly population, we, our clients are referred to us from long-term care agencies,
[3:44] such as, you know, like, inclusive, my choice. We get referrals from the hospitals,
[4:06] from
[4:06] a screen is done to determine eligibility within our program. And then once they're in our program,
[4:15] we, as a nurse, I do a lot of the medication management. I pick up their meds from the pharmacy.
[4:24] I educate them on the medications that they're on, set them up in planners, whether that be, you know,
[4:35] with on a daily basis via phone just to do like a mental health check in, make sure they took
[4:40] their medications and then a lot of collaboration with psychiatrists and you know medical providers
[4:49] to just kind of meet them where they're at and help with any of you know like a point in needs
[4:55] or just understanding of any of their medical diagnosis or psychiatric diagnosis.
[5:04] could I just ask before we move on what what is how do you screen and what's the criteria to always that where we're going next?
[5:13] Well, we so it's not really a screen-in or screen-out process. Once we receive a referral,
[5:21] we discuss it as a team. So Jamie is part of our team and then it's the three of us.
[5:26] And then Dr. Percy, who's a psychiatrist from Temple County Health Care Center.
[5:30] And then also, we have a clinical coordinator
[5:33] who was from Lutheran Social Services.
[5:36] So we kind of screen them and then the processes
[5:40] that they, the functional screen is completed.
[5:44] So that tells us if they're eligible or not.
[5:47] For CSP, you don't necessarily,
[5:49] the screen doesn't necessarily have to be done,
[5:52] but it's just more of something that's done
[5:55] throughout this state, just as best practice to verify
[5:59] that they're actually eligible.
[6:02] We meet with the clients several times also. It is a voluntary
[6:10] program in last area on a chapter 51 or a commitment. Then they can be court ordered to be
[6:16] in the program. So otherwise it's voluntary for them.
[6:31] Again, just because our social worker
[6:33] And she does a lot of appointments to and takes people to and from places and sometimes just clients want to get out of the house and they just need a ride. Maybe they don't have transportation and they're they're homebound and so she'll they all kind of do that but Jessica does a lot of the paperwork and the annual reviews six month reviews different things like that and goes over all that paperwork work with them.
[7:04] And then we have Ronda.
[7:07] I do a lot of the transportation,
[7:10] taking them to appointments or taking them shopping.
[7:15] Sometimes I go in appointments with them,
[7:17] and sometimes they just don't want you to.
[7:21] I do a lot of the gathering of paperwork for the reviews.
[7:41] So
[7:45] this program is just for those that are chronically have a chronic mental illness.
[7:54] So that's where your referrals come in.
[7:57] Yeah, okay. So is Dr. Pursing on contract then with the county to provide those services for a certain number of hours or just based on
[8:08] Yeah, we talked about that on the front end and we could we could do more, but we thought I think we have two out two two days a month for two hours each
[8:18] Correct, and I think it's like the second and fourth Friday days or something like that
[8:24] Where we the whole team meets basically four hours and right four hours
[8:27] them on right now. We said if we need to increase that we can, so this is a state reimbursed
[8:32] program to a certain extent, and then there's a portion of Levy in there, but yeah, for the
[8:38] most part, the vast majority of this service is state reimburs. How long has Dr. Percy been in
[8:43] that role? We just, he was doing it informally for us for a period of time, and it was,
[8:50] and obviously he has to prioritize, you know, and I think it was mostly because he was the psychiatrist
[8:56] for many of the folks that we serve. And so we thought, you know, it makes more sense. We can
[9:02] get reimbursement. The healthcare center can get money for his time then as well so that he's not
[9:07] having to do it in an informal basis. So, so we created the contract was it last year?
[9:13] I thought it was, was it last year or 23? Or late? No, it was. It might have been late 24.
[9:19] or maybe it was late 24 or
[9:21] five or never, right?
[9:22] Yeah, it hasn't been much over a year, I don't think so.
[9:27] But yeah, it hasn't been terribly long,
[9:29] but we thought, let's Jerry and I talked.
[9:32] And so let's make this a formal agreement.
[9:34] We can tweak the hours if we need to,
[9:36] but this seems to, I think our frequency and the amount of time
[9:38] seems to be working well.
[9:40] I was just gonna also say the clients
[9:42] that we have an RCSP program,
[9:46] they I think it's all but one see him as a psychiatrist so it's nice they see him at West
[9:53] Central behavioral health clinics so we don't have to you know like the four hours that we're using
[9:59] every month is for direct staffing with with all of us they go and see him at the clinic there and then
[10:07] if we have any issues it's nice that we can just you know usually you can just give him a call or
[10:11] can shoot him an email and if he's with a different county he can give me a call if we have
[10:16] a client in crisis and so yeah it's been really nice to be able to have that extra staffing
[10:21] with them and yeah I have a reason yeah yeah I was just curious because we had just talked about
[10:25] this actually on at the health center where we were like that depressing had had to
[10:30] spoke into us about all of the services that he provides including services to other counties so
[10:35] this I was I never asked them at the time like what kind of volume he was or time spent
[10:42] so I was just curious but then just one last question from my and what is volume capacity or
[10:48] client capacity for this group is there like a limit of number of people you can have and serve
[10:54] so for DHS 63 it's 20 20 people in the program we can have more but then we
[11:05] have to add more staff. And we do have one person that is trained to come on board. Let's say we
[11:12] had five or ten more people referrals came through when they were pretty significant. We could pull
[11:18] that cross-trained person to pick some of that up and to help with that. How does one graduate from the
[11:25] program. Do they ever? Like, I mean, what's the Evan flow of intake and output?
[11:32] Do you want me to talk about that? Okay. So in CSP at various, some folks choose to
[11:40] just leave the program. They feel that they don't need it anymore. They maybe they
[11:45] have other supports that can help them or they've gotten to the point where they
[11:48] can take their own meds. They can go to their own appointments. And some people are
[11:55] it forever. We like to try to teach them and get them as independent as they can because
[12:03] of course, you know, nobody really wants someone in a program forever because you want them
[12:08] to be able to live independently and do their own thing without anybody coming into their lives
[12:14] and knowing their business. But some people really depend on us and really like to have that
[12:19] because they don't have any other family.
[12:21] And again, a lot of that transportation issues
[12:25] to or being able to get to the grocery store
[12:27] and they like the company.
[12:30] There's a gentleman that we have in the program right now
[12:33] that he doesn't get out much, but he gets a ride.
[12:37] Just goes around just once a ride, once a week.
[12:42] And during that time, then the staff
[12:43] is assessing his mental health,
[12:45] assessing if there's any addiction issues,
[12:47] assessing if there is any maybe physical issues because this person does have physical
[12:52] issues or they able to walk or they struggling, have they fall in. So during that ride,
[12:59] they can kind of assess that stuff too. But yeah, they usually, it's either, they don't typically
[13:04] graduate, they either say, no, I don't need it anymore, or we kind of talk to them and be like,
[13:11] you know, you're doing really good. Is this something you would want to try on your own
[13:15] and still maybe keep in touch see how goals because you can always come back in and out into the program.
[13:21] I think that there's a contrast between that. So get folks with severe and persistent mental illness here.
[13:27] And then our CCS program is more of a recovery based program. So that's that's where not that we wouldn't
[13:33] try and build independent of both programs. But that's intended to be a shorter term program, you know.
[13:40] Do you, does your department or does the state do any quantification or statistics as to how your programs going and how many from maybe whether they're presented to you by the courts or some sort of other crisis do you put that data together or posted with the state?
[14:09] Well, I'll be honest, I just became supervisor for the program, so I'm kind of learning to and learning kind of all the ins and outs with the state.
[14:18] I do know that they have reviewers that come in every couple years and go through everything.
[14:25] It's one of the most extensive audits or whatever you call that I've seen and they go through everything.
[14:36] now I haven't found anything that necessarily is statistical so far in my role that doesn't
[14:42] mean it's not there. I'm just kind of learning, but I would think the state does keep track
[14:47] of some numbers of some type, and when I do find that, if that exists, I'd be more in happy to share
[14:53] about. I think on my end what I think it would be nice to see would
[15:00] It would be data that supports the success of the program, right? I'm sure it's successful. There's no doubt in my mind that it's successful. So there is likely already data that's collected on the state side to show the success of the program, or they probably wouldn't continue to partially fund it, right? But locally even knowing what those numbers are and the, I guess I would think like probably avoided mental health admissions would be something that you would probably want to track or that type of thing.
[15:30] Um, but I get where you're coming from that you're new to it and still trying to figure it out.
[15:35] So yeah, we we do also send out surveys to the clients.
[15:40] Um, that's annually, I think, when did we do that and we do it in October?
[15:46] I'm going to say it in the water.
[15:49] Yeah, do in our July.
[15:50] Oh, okay, yeah, do in our July.
[15:52] Not October, but we send those out to the clients.
[15:55] So of course we can't guarantee that we're going to get any back, you know, just with the population that we're working with, sometimes that can be difficult. But we have gotten a few back in the recent years with some feedback regarding, you know, us as workers and the program in general.
[16:17] And I will say if I can share just, I think it's a great big success story that I've seen so far in this person was on a commitment for a little bit very short time, but the hospitals and ambulances and law enforcement,
[16:36] everybody you were calling us constantly about this person who keeps going into the hospital.
[16:42] And I mean, it would be a couple of times a week. And they have that right. You know, they can go
[16:47] in the hospital as many times as they want. The person didn't want services. Just felt this place was safe.
[16:55] Could take a little break from the family. Since that person has been and then I've been going on
[17:01] quite some time years. And since they have come into our program here, boy, I would say
[17:11] it could hospitalizations if I had to put a number out there by like 95 percent.
[17:17] It's huge. What these folks have done with this person and the family, not only just that person
[17:25] who still struggles and they still have to work with them and try to keep them out of the hospital,
[17:32] I, they had asked me to sit down at a meeting recently with the family because the person was coming out of a facility and I was able to watch them work with the significant other.
[17:46] The sun was there and the sun is younger, but no is enough about what's going on and the sun was there and the support and the plan that everybody put into place, but when I first had the person on a commitment I couldn't keep the person out of the hospital.
[18:00] Usually, I'm the person that would put people in the hospital if they weren't doing well, but I was trying to get the person out in this is the team
[18:09] The program that was able to do that and it was a huge change.
[18:13] It took a little bit and working with male hospital,
[18:16] Gundersen because the person kind of floated around a bit too
[18:20] And not only does the person have a severe and persistent mental illness, they also have an intellectual disability on top of that.
[18:29] So, that made it even harder, but this program did really well with that person and others,
[18:36] but that's the one that just really sticks out to me because I can confidently say it has
[18:42] me like 95% improvement with this person.
[18:49] So, and actually calling in wanting to go places, wanting to go to Walmart, wanting to go,
[18:55] grocery shopping or not isolating because that's what the person would do.
[19:07] Any other questions?
[19:14] Yeah, thank you.
[19:15] Thank you.
[19:15] Much success to your program.
[19:19] All right.
[19:21] We will move on.
[19:23] Public health and DHS 140 review.
[19:27] I do not have a whole 10 minutes to talk about it.
[19:32] I just made sure I gave you plenty of time.
[19:34] That's all.
[19:41] Yeah, so Public Health Unit, we have successfully completed the DHS State 140 review.
[19:48] And the review was August the 12th.
[19:52] Renee and Jay has stayed the whole time there.
[19:56] Which is really grateful for that support.
[19:58] Yeah, thank you Renee.
[20:00] Thank you for being there.
[20:01] It was a honor to be there.
[20:03] Yeah.
[20:05] That I was there.
[20:13] Sorry Scott.
[20:14] And in times I leave you all, I really enjoyed being there. I was grateful for having been invited and I learned a lot.
[20:24] It was a whole three-hour long, so it was good though. I think it was really an opportunity for us to see where we still,
[20:33] where our highlights we tell the state about it and also where we still have gaps and we can improve on.
[20:38] So, everyone who participated in our staff, they did really great also talking about their
[20:44] position and programs.
[20:46] And the state has confirmed that we will be re-certified as a level 2 health department.
[20:52] They're still writing the official report and then it has to go to the state health
[20:56] officer for signatures.
[20:57] So, we may get that hopefully by the next board meeting, I could share the report with
[21:01] the board.
[21:04] Great job, you guys.
[21:05] Hi, and her team have done excellent.
[21:09] Yeah.
[21:09] Congratulations, everyone.
[21:11] Thank you.
[21:12] You know, if I could comment on it all,
[21:14] everyone was so at ease,
[21:17] then eager to talk about their program.
[21:20] It was very, very, very great.
[21:26] Well, I'm glad we looked like that because we were all patting.
[21:29] No.
[21:31] And you worked interactively.
[21:33] you shared and I think you weren't cooperatively was great. Thank you. Yeah, I think it depends
[21:40] through what type of state inspector you get and some of them it's if you even crack a smile.
[21:50] Nope, there's another tick. So good job, though, you guys.
[21:58] Were there any recommendations for improvement?
[22:01] I haven't really seen the report, but I do believe when we talked about quality improvement.
[22:06] There was a bit of, they were saying, hey, this is a difficult area for a lot of health departments because, you know, we have such high turnover, a lot of times we're spending time changing, training new staff is looking at programs and trying to improve the quality.
[22:20] So I think that's some, I think we may see some writings in that and I think that's pretty common.
[22:26] And yeah, hopefully we've been here long term, we'll get some...
[22:33] That's a recommendation that's probably provided to every health unit out there for quality improvement and those types of things, but that's a great goal to have and to work on.
[22:44] And you're going to be here for 20 more years, right?
[22:46] At least.
[22:47] Okay, good.
[22:52] Anything else for Kai?
[22:55] All right. Thank you, Kai.
[23:10] I don't know if you need it closer to your mic.
[23:15] I have that problem every which was that better?
[23:18] Yeah.
[23:19] Okay.
[23:21] I had a bad plan around in my bedroom.
[23:23] And when that happens,
[23:25] now the recommendation is that if you don't touch the beds
[23:30] And you don't know whether you are meeting or not,
[23:34] you go through the procedure with the seven shots.
[23:38] And I started with Diane, she gave me lots of good information,
[23:43] ended up going to go to Mayo ER in the cross
[23:46] for the first four shots, and then there are three more.
[23:50] The others, I'm in first two, and then the last one, I'm fighting.
[23:55] So I just thank Kyle for sending me in the right direction.
[24:02] didn't know when I called the nursery, I just meant they don't have the first four shots
[24:09] at the clinic. So you have to do ER from that. And the nurse that provided the shots to me said
[24:17] that she thought there was some sort of a mating of the mass or something, but she had a family
[24:23] of five that came in and had to get shots and several other people. So it was kind of a run on
[24:29] and shots during the last few weeks.
[24:32] So, thank you, Confer, help it me out.
[24:37] Very good.
[24:39] Thank you, Scott, for letting me know what end of happening
[24:42] because we didn't have the bad.
[24:44] We didn't have a specimen to ship.
[24:46] And then I was like,
[24:48] well, there's not a visible bite.
[24:50] Either, so I'd just recommend it, Scott,
[24:52] would go talk to his doctor.
[24:55] So,
[25:00] great.
[25:00] All right, thank you, Kay.
[25:01] I said one more thing I did forgot about, this guy mentioned that didn't have the bat.
[25:08] If you can catch the bat, put it in a coffee can and get it to, I don't know, I don't
[25:15] think our humans are saying here does it, but they said the humans are saying it across
[25:19] county, and then they said it to Madison, and they checked that they would use the nice
[25:25] it, said it to Madison, and if I had gotten the bat, I probably wouldn't be taking the
[25:31] unless it comes back that we've had babies.
[25:34] So, now I'll be quiet.
[25:37] No, thank you, Scott, for sharing that.
[25:42] All right, any other questions for Kai?
[25:46] All right, thank you.
[25:49] We will move on to the update of the Tremple County case.
[25:54] Yes, so I was asked to provide an update on Tremple County case 25 CV-191.
[26:01] Victoria Purison versus Trimble Oak County, back on June 17, the court did find for the
[26:08] county through what's called the summary judgment motion. So at this point, basically,
[26:12] the case is done. We are not concerned about an appeal at this point, so everything should be closed.
[26:21] Good. Good outcome. Thank you. Thank you.
[26:28] All right. There isn't anything else you have that
[26:31] you tell us about the case because we're not in closed session. I'm assuming that I want to keep it kept in place.
[26:40] Yeah, yep. Okay. Thank you.
[26:45] All right. Next up we have Jay for the his director's report.
[26:52] All right.
[26:54] So we've got a few new folks, few new hiders.
[26:58] One is Jaden Sucle, she's our new program aid, and we actually have this time able to hire her
[27:05] with some overlap before Peggy retired. So Peggy could kind of show her some things and some
[27:10] other folks could as well before Peggy's last day. Peggy's last day was this last Friday and we had a nice
[27:16] outgoing way of party for her. So that was like I say I always say that's the only time I want to see
[27:21] somebody of our department is when they get to retire.
[27:25] And then we also had Kristen Fry, she was our records custodian before and she applied
[27:33] to become, when Tina was promoted to the fiscal manager, Kristen applied for the provider
[27:38] network developer in contracting specialist position, so she went from records custodian
[27:42] to that position, so position change internally, but she's technically newly hired into that
[27:48] position. So then conversely, that creates a vacancy with the records
[27:53] custodian position, which we are either in the process of posting or
[27:58] actually I think we already did post and we've got some applicants. We just
[28:02] were proceeding through the hiring process for that. We still have two ongoing
[28:08] social worker case worker positions in child welfare and that's a unit that
[28:15] struggled since before I got here to stay fully staffed. It's just the nature of the
[28:22] and the intensity of the work is really challenging sometimes so.
[28:26] How do curiosity do you partner with any of the area universities or text schools to like
[28:31] do internships or anything to try to get people in? Yeah and that's one of the ways we've actually
[28:36] gotten I bet like at least three or four of our staff. Unfortunately some of them
[28:43] If we could get them to stay past a year, but it's always circumstances, you know, so it's,
[28:49] oh, I'm going back for my masters or I'm moving to a different, you know, county, or something like that.
[28:55] And so, or sometimes it is the way, you know, and I mean, that's just kind of the being between two larger counties like lacrosse and
[29:03] player and even some further west.
[29:07] I mean, it's kind of challenging.
[29:08] But yeah, we have had some a number of interns
[29:10] from both Winona State and UWO Clare and actually
[29:15] one of the professors at UWO Clare.
[29:18] We had contracted with her for a little while
[29:19] to help us get caught up on some reports internally.
[29:23] She used to work in the field, and she was a supervisor
[29:25] and child welfare as well.
[29:27] So she has helped us at times, too, as an advocate,
[29:32] And as her students give her some feedback on, you know, hey, what's it like to work for
[29:37] Trump, lo County?
[29:38] That's been a good pipeline, a pipeline is a little interesting word, but to help us get staff hired
[29:47] in those positions, so yeah, we're talking about different methods for retention and things
[29:54] like that.
[29:56] It's always challenging, I think, you have some units that are always...
[30:00] Police staffed and some, especially with the more intense services like child protection, that it's more challenging.
[30:08] And I think it's still holds true. I know I've heard the staff a few years ago where the average tenure of a child welfare worker in the state of Wisconsin is two years.
[30:17] So.
[30:19] May I ask?
[30:20] Yeah.
[30:20] Do they sometimes rotate?
[30:22] Based on such matter then?
[30:25] Like, for instance.
[30:29] I was trying to address my team.
[30:33] Is it difficult for a department to then change what's the right word?
[30:43] Specialties, focuses.
[30:44] It's, oh, sure I see what you're saying.
[30:47] Like, do we see chips, sexual assault, do they sometimes rotate them around, or not?
[30:54] I'm just wondering, I don't even know what to say when it's only two years.
[30:56] So, right, I know, so it's, it's, I think we've tried different models.
[31:03] And some counties will say, they'll split them apart and actually we do this as well.
[31:10] So we've got investigators, which they're called our initial assessment workers.
[31:13] So when a report comes in, then they're the ones who will screen it.
[31:20] And the worker who takes the access worker who takes the report,
[31:23] screens it, then talks with the supervisor and then the whole team kind of consults on whether
[31:29] it's going to be a screen in or out.
[31:31] If it's a screen in, what level of intensity and what level of response time.
[31:37] So that's, and then they go out and they investigate the initial assessment workers.
[31:42] So they kind of think of them as like the detectives or whatever.
[31:45] I mean, they really are very similar to when law enforcement does investigations.
[31:49] And in fact, they are together a lot of times.
[31:52] They'll take long enforcement with them, especially if it's some kind of a situation where they don't know what kind of environment they're going into or anything like that.
[31:59] So that's the initial assessment.
[32:01] Then we have what we call the ongoing workers.
[32:03] And they're the ones who once the initial assessment is done,
[32:06] and this these folks are gonna stay with us,
[32:09] we've opened the case, then they take on the longer term case
[32:12] man, and by longer term it, it's not intended to be forever,
[32:16] it's just, that's the longer piece of,
[32:19] if children are removed, you know,
[32:21] how do they, is, is reunification of the family possible,
[32:25] or does, do other things need to happen before that could happen?
[32:28] Because that, that would be the ideal situation
[32:30] in any scenario where children are moved,
[32:32] or where we take temporary physical custody.
[32:34] So, but so we've got them separated that way as opposed.
[32:39] Some counties will do, you take the referral right from the beginning and you work that case all the way through.
[32:46] I will be wondering if the two is there any data that shows that turnover is better in one way or another?
[32:53] Not that I've seen, but typically we've been more, it's been more difficult to find initial assessment workers.
[32:59] Well, and I think I can see how the non-E-Pace actually because of the intensity.
[33:05] But now we're fully staffed in initial assessment and then we have two ongoing openings.
[33:09] So sure. Yeah. So it just sometimes it's like circumstances, but I mean, you know,
[33:15] there's all the different factors that play into that.
[33:17] But yeah, we're talking about different methods for attracting and retaining folks.
[33:23] Because I think we've done a lot of work.
[33:26] I mean, a lot of work on our environment
[33:28] and recognizing folks and that kind of thing.
[33:32] It's just, we're trying to figure out
[33:34] what are the main reasons that people are leaving
[33:36] and we're typically getting younger staff
[33:38] and so they're at the beginning of their career
[33:41] and many of them that have decided,
[33:44] I'm gonna go back for my master's now.
[33:45] I've got some experience,
[33:46] I'm gonna go back for my master's
[33:47] and then, or they're gonna go, you know,
[33:50] I've got some people, I'm gonna get my master's
[33:52] but not in social work, but in counseling.
[33:55] or something like that. So it's just, we've done a lot of digging and trying to figure out
[34:02] how can we do things differently? And we've tried to reach out to the internship sites as well,
[34:08] you know, the universities and the folks we know there and kind of pick their brains a little
[34:13] bit too. So if you have any ideas, we're willing to try a lot of different things.
[34:19] When I trust that you guys are probably looking at all of that, but I just feel like that's something
[34:22] that this group, you know, that's our purpose, right, brainstorm, right? Yeah, absolutely.
[34:27] But, you know, so like. So if you have ideas, yeah, for a moment. Well, I mean, I don't know
[34:35] that I have ideas, but I just replace this to look maybe or so you know what I mean?
[34:39] Would it help with satisfaction to have somebody who's able to partner with them anytime
[34:45] they go into a home? Like, I know I would feel really uncomfortable and it's one of the reasons why
[34:50] home health is difficult to staff because the environment can be very hostile and dangerous and
[34:55] all of those things so I can see where that could be very draining on a person and you
[35:00] know that so and I know a lot of times I take law enforcement but I would imagine they feel guilty
[35:05] and using somebody to go with them in these cases when they don't know like I can see that that
[35:10] would also be oh I shouldn't need to have to ask them for help but I don't know like so then
[35:15] think to myself is there's some sort of a technician position. I don't know what it would be. Security type
[35:23] position that would somehow be able to go on these cases. And I don't know what that would look like
[35:30] because I know there's multiple social workers out in the field at any given time. And so how would
[35:35] you do that? I don't pretend to know. No, it's a good thought. It's a good thought. And so there's
[35:41] different steps along the way because the hiring process is the very, very, very, very beginning.
[35:49] But once you get in, so there's in both of those types of positions, there's six months of
[35:54] training through the state that has to happen before they can even have more than half a case load,
[36:01] but in, and I, we've tried to get better with our onboarding processes to in a sign them like,
[36:06] I don't know if it's a formalized mentor or not, because we've got a lot of different
[36:10] experiences that they should see. And so we do send them out with different folks,
[36:15] you know, into the field and that kind of thing. And then somebody else will go with them as well.
[36:21] Law enforcement has been very good and very welcoming about saying, hey, if you don't know,
[36:27] or if you feel unsafe, or if there's a history that the department knows about, you know,
[36:33] don't be afraid to reach out and ask us to go with, you know, which is very much appreciated.
[36:40] So but we're trying to get better about like on that front and the onboarding process.
[36:44] What are, are there any gaps? Are we missing something? Do people, is that where the comfort level starts to come in or not?
[36:53] And then, um, another fun, I just, it just blew the coop, but, um, oh, we also have, well, what,
[37:01] what I just call a new staff with with Jay and Trisha, um, sounds like a variety show.
[37:09] But it could be, I suppose,
[37:13] but so we have anybody who's brand new and we don't make the supervisors come and sit with us or anything like that.
[37:20] But we want people to, well, A, we want them to meet us and say to put a face with the name, know that we can, anybody can come to us at any time.
[37:32] We want people to be able to talk to us, but also we want them to tell us, and we've got a list of questions in a script, and we go over your chart and hey, here's where you fit in, talk to tell us where you come from, tell us what your experience is, and now tell us, because people at that time have been here anywhere from a few days to a few months, and because we only have it every other month, and then they can tell us from wherever they are in the process.
[38:00] What did you like? What do you wish you had known? What would you recommend for us to do in the future?
[38:06] So we've got some basic questions like that where we get feedback and maybe it's too early on in the process.
[38:11] I don't know but like we're trying to figure out where is the sweet spot.
[38:15] And some people they can't make the first one that they are here for.
[38:18] And so they are here for three or four months or something like that.
[38:21] So we try to we're trying to mix it up and see you know what feedback we can get from people too.
[38:26] So, so I welcome anything, yeah, it's got Jay, do you have a training person then that goes out with the person the first time they get a call or do you have anybody who was cis so that they can ask questions and say how did you do it?
[38:43] You know, did we do it correctly, right? Is this a common occurrence? You know, just questions like that.
[38:49] Yeah, we do. We don't want to, we don't want to throw anybody into the fire and so I think we do it multiple times.
[38:55] And they might even, and I haven't gone up with them, so I don't know exactly how that
[39:04] flow goes, but I know we've talked about having them go out, and the seasoned person will
[39:12] do it first.
[39:13] And you just shadow, and you shadow a couple of times, shadow different scenarios and that
[39:16] kind of thing.
[39:18] And then once that person is ready, and knows they've gone through their safety training,
[39:24] And if go on through a lot of that stuff, even if the six months isn't complete with their training cohort,
[39:31] then they can take it on.
[39:32] And then this person can kind of supplement if they're asked different questions or redirect the conversation a little bit.
[39:39] Then I think that probably happens a couple times as well.
[39:42] But those are the pieces.
[39:43] Those are exactly the pieces where I thought, is there anything we can strengthen there?
[39:47] Or can we change up that cadence a little bit or lengthen it a little bit?
[39:52] So we're asking a lot of different questions, so I appreciate that the thought because we're really trying to rack our brains.
[40:00] And so the other, as you have all that turnover, what I've talked with with not just child welfare,
[40:07] but like all the units is, how do we get people in and acclimated more quickly so that so that they can be productive and not that we're going to throw them out to the wolves?
[40:20] But how can we get them up and running faster?
[40:23] So that they know to ask better questions.
[40:25] They know to feel comfortable to ask for help,
[40:28] or to ask for law enforcement to go with,
[40:31] or that kind of thing too, or so.
[40:33] And I think that's key.
[40:34] I think that they have to feel comfortable.
[40:36] They don't feel comfortable.
[40:37] They're not going to stay.
[40:39] I mean, that to me is what I've seen throughout the years
[40:42] is if they aren't comfortable with the position,
[40:45] or they aren't comfortable with how the job works,
[40:48] They are not going to stay, right?
[40:50] Right.
[40:50] I just think a couple of things come to mind is when would you ever feel safe going out to a resident in that scenario?
[40:57] I don't know that I ever would because it's true.
[41:01] That's bottom of the barrel situation, right?
[41:04] Like things are not good.
[41:05] It's emotionally charged, right?
[41:07] So I just always feel like that's never going to be a scenario that I feel like I would feel completely safe going into without somebody else, you know, being with me.
[41:15] Right.
[41:15] number one. Maybe until you know the family a little bit better too, right? Yes, but
[41:19] initial, right, when you go all of the times or something, I think that that's, um,
[41:24] the, I just, yeah. And then my, I just, one other question, I've heard you say multiple
[41:29] times that staff leave to go back for their masters. Why can't they get their masters and
[41:34] stay? They could. Is what I'm getting. Yeah, I'm sorry for laughing. I know. But is there,
[41:42] But what I'm saying is, is there any professions do that?
[41:46] Is there reimbursement associated with obtaining your masters?
[41:50] Do we honor that?
[41:51] What is the reason they have to leave once they've obtained a masters?
[41:55] Yeah, we've actually, we've had one or two people say,
[41:58] you know, what I think I'm going to work because we don't have any reimbursement through our department.
[42:02] I mean, we've never done anything like that.
[42:05] Could we?
[42:07] I mean, you would retain knowledge and excellence.
[42:10] and it might be worth thinking about.
[42:13] Right, and that's, and we've talked about that internally, and I mean, we, if, if, if they're
[42:19] support for that, I mean, I'd love to see something like that.
[42:23] Wow, I mean, who wants to do more money, but, but you're spending more money by having
[42:26] continual turnover than you probably will be.
[42:28] I know.
[42:28] Turn over.
[42:29] I know.
[42:29] Turn over.
[42:30] If you utilize universities or where they're going to get their masters to partner
[42:36] with them to share and trust.
[42:39] Why we're giving them training and they're getting their degree.
[42:45] And so the university has a super grad, right?
[42:48] Right.
[42:48] Or could we say you can go down to a half-time position
[42:52] while you're working half-time on your reimbursement.
[42:54] We'll pay you.
[42:55] Like there's a number of credits you can still
[42:59] have health insurance, things like that.
[43:02] That might be worth it.
[43:04] The other thing I was going to say is,
[43:05] know that there's, there is so much more burnout with child welfare than with adult cases
[43:15] because it is so much more emotionally charged. So do you provide just regular intervals
[43:24] at which you do debriefings? How is that handled? Because I would think that if somebody's
[43:29] And that, and more often than not, most employees are going to request a debriefing.
[43:37] They're just going to go until they fall apart.
[43:41] So if you maybe that might help once you get an employee in that they have those debriefings
[43:49] or that they're allowed that on any given day, if they've had a bad morning case, that you
[43:58] just go home for the afternoon or somehow they have a break whether they're in office or home,
[44:04] life, whatever. I think it needs to be more personalized probably to the employee and what
[44:12] they consider. Yeah, I think and maybe being more intentional with that because we we kind of do
[44:20] it that team has all historically at least since I've been here has been really good about
[44:25] Like being supportive of each other and they they really because I think it's because you're in such an intense
[44:31] Well, you know, Scott. I mean, you know, law enforcement. I mean, it's the same thing. You're all you're all in this really intense
[44:38] Right and you support each other and right and I've seen it happen a lot naturally and I've kind of jumped in and said you should just go home for us
[44:46] I mean, and I think Trisha's done the same thing too, but it's
[44:49] Is it as intentional maybe as it could be and that's kind of that was what I was putting down here's more intentional
[45:00] Especially when you've had some kind of a pretty intense or a confrontational type of experience, you know.
[45:07] Even if it's where you earmarked one hour of debriefing with
[45:16] the psychiatrist.
[45:18] Or clergy, or I mean, I definitely...
[45:20] Well, we have, we always refer people, or don't always refer necessarily, but we give them,
[45:26] or remind them and give them the number to EAP for your free counseling sessions.
[45:30] kind of thing because I think that's important too. I just know in trauma type scenarios are in health care,
[45:37] with trauma that debriefing has become very significant with an intentional schedule,
[45:44] debriefing after a meet trauma or, you know, that type of thing. And what else they have to
[45:49] being in health care for so many years is a new nurse. I maybe was sitting in the debriefings,
[45:54] but I would have never spoke up because I would have not felt comfortable doing that around my peers
[45:59] for fear of, you know, not not being considered good enough, maybe, or strong enough, or whatever.
[46:09] Or talk for whatever.
[46:10] Right, right, right.
[46:11] And I think that's a misconception too.
[46:13] Maybe, maybe less soul in child welfare, but I know a law enforcement.
[46:18] And probably is to accept an extent.
[46:20] But yeah, I mean, it's, well, it's not about being tough.
[46:23] It's about being able to take care of yourself and keep your mind set in a good place.
[46:29] But like Don says that's very difficult. It's difficult for law enforcement officers to go out there and say hey
[46:36] I need help because they're afraid that'll be reported if they go to EAP or whatever for assistance
[46:42] Oh my god, I'm gonna have a strike against me and you know
[46:46] I'm gonna lose my job maybe or whatever so they're more willing to keep it within themselves
[46:52] And not get the help that they probably should be getting
[46:55] Right, then what I see with the debriefings is it's usually led by somebody outside the department like like it. It doesn't have to be clergy, but that's what comes to mind clergy or
[47:03] A psychiatrist or whatever and then they'll perform activities that aren't like tell me about how everything went bad, but they'll do actual activities that bring that out
[47:15] In other ways, so it's not like you're saying oh my god
[47:18] I had this situation that was so terrible, but those things come around kind of
[47:23] naturally through the activities that those people develop.
[47:27] Yeah, that's a really good idea.
[47:28] I will say we do get together Monday morning and discuss kind of where cases are headed.
[47:33] I mean, it's not quite to the same of like sort of, you know, debriefing how you're processing
[47:38] and all that sort of thing, but I do think there's an element of that there when you're discussing
[47:43] where this case is going, where you're thinking about it, and they talk a lot.
[47:48] I mean, they're very collaborative in that process.
[47:50] And I'm not trying to suggest that the team's aren't supportive of a one-on-one, I just threw my history
[47:55] know that even if you are supportive of one another, it's still sometimes not enough.
[47:59] And whatever we can provide to give them that additional support is no harm, right?
[48:03] Yeah, I completely agree. And sometimes maybe we're so immersed in it that
[48:09] that we're not thinking of something that's obvious too. You know what I mean? So we all have blind spots.
[48:15] So...
[48:15] No, just a minute. Thank you. Yeah, appreciate that.
[48:17] the masters, then that really bothers me when somebody leaves to go get a master.
[48:20] I know.
[48:21] Thank you.
[48:22] We're with the social work with your masters because one time ago I used to work for
[48:26] social work masters program and the clinical hours.
[48:29] So I don't know if you're able to work with people going through that program, but the clinical
[48:33] hours that they have to do during the weekday.
[48:35] I know that was a barrier to a lot of the students staying in their employment at that time.
[48:40] Because there's weekend programs available for the classroom portion or online programs, but
[48:45] getting those clinical hours that in trying to navigate that, right? But I think you could get
[48:51] creative there. Why do you have to work Monday through Friday in CSP? Why couldn't there be
[48:56] potentially somebody work on a Saturday so they can do their clinicals on Wednesday or whatever
[48:59] it might be like, could we just look at that and see what opportunities are to get creative and
[49:04] try to attract that level of education and then longevity? Yeah. Yeah, it is possible. It's just
[49:11] We try to get around the logistics of the, well, I guess that's not even.
[49:17] And the two people that were in the position, now I'm probably going back four or five years
[49:24] that were in child welfare, they were here for a very long time.
[49:28] Mark was here for 29 years.
[49:29] Yes.
[49:30] Everybody kept telling him, I have no idea how you did that.
[49:33] Right.
[49:33] Yeah, but I think or maybe you even go back to him and pick his brain and say
[49:42] We know that you stayed in this for a very long time. What special characteristics or what types of things helped you
[49:52] To reach that
[49:54] It's actually he had a lot of conversation with Mark before he left because and people would pick his brain all the time
[49:59] and I think he was able to
[50:02] And I don't think everybody can do this, you know, but how do you do the best version of it you can?
[50:10] Where he was able to, there's a lot of people, they do this work because they're invested in it, you know?
[50:20] And so they get so frustrated and wrapped up in what they're doing, and if they can't do and can't resolve things the way they'd like to see it,
[50:31] It's hard to let go of that sometimes, you know what I mean?
[50:34] Especially if you've had personal experience, so it's, I think he was able to, not that
[50:41] he didn't care, quite the opposite, he really did, but he was able to say, probably wasn't
[50:49] easy.
[50:50] There's nothing more I can do here, I've done everything I can, this is the right decision.
[50:55] We've tried to give people the tools or, you know, that kind of thing.
[50:59] That's part of what I saw and a lot of people would, like you say, pick his brain, you know, for years too. So, but yeah, we couldn't, we could still, you know, see if he's got any other suggestions too, because
[51:13] Yeah, he's the only one I know of who was here such a, for such a long time in CPS, I'm sure there's probably other people.
[51:20] I'm trying to think of her name. There was a woman here that was here for quite a few years.
[51:25] Not near as long as Mark. She had longevity too. I want to say she's here like 15.
[51:31] Oh, okay. Maybe that was before I got it.
[51:35] It was before you started. Oh, it was okay.
[51:39] Oh, no. Why totally do you know?
[51:44] I'm sorry, Scott. I'm sorry. Scott still has another question.
[51:47] Yeah, and the same side.
[51:48] Yeah, go ahead.
[51:49] Does the state have any programs for reimbursement for the master's program if they could
[51:57] get credits for and have reduced amount of credits for the program, state sponsor, or state
[52:05] assisted, or they pay for credit versus three credits, or any type of reimbursement from
[52:12] the state in getting your master's?
[52:14] I don't know.
[52:15] That's a good question.
[52:17] just thrown it out there
[52:22] actually we're working I would think you're a
[52:24] being sent of from the state right to throw their hat into the ring if the
[52:28] person is working in
[52:30] Actively pursuing the educational as, you know, for their masters or whatever. Right?
[52:37] Yes, we're not the only county that is hurting for child welfare. Right.
[52:43] Well, if there's not, we could add the key for it. We sure could.
[52:47] All right.
[52:52] Thank you for the ideas. I appreciate that.
[52:54] What else do you have, Jay?
[52:56] Just a few things I'll buzz through here. We have, we finalized our position
[53:01] questioners for the wage study a couple weeks ago and then the review process and all that. So
[53:07] we got everything we needed to hopefully to a graph for them to do their analysis and everything.
[53:13] So that's having that in budgets and different things at the same time was challenging but we made
[53:18] it work. Well, budgets aren't done yet but we're working. Yeah. Yeah. Yeah, it's always over doing progress.
[53:27] And then we on August 17th, we posted the case management software RFP and we've had at least 10 vendors interested, so yeah.
[53:43] We're excited about what the end result. There's a lot of work right now, I'm not gonna lie to that.
[53:51] A lot of things we're going through right now, so, but yeah, that's going to be an excellent.
[53:55] I mean, we're all of our programs that don't have a state system.
[54:00] We intend for them to be in this system, so, and that will filling in claims and everything
[54:05] be integrated and it should create a lot of efficiencies for us, so we are very excited.
[54:11] Some of us more than others, there's a few of us who are really, really fired up for that.
[54:18] I talked about budget work, we've got one of the reasons that we're kind of struggling a little bit through our budget this year as we've got and not against them at all but we've got a new fiscal manager and new fiscal lead who haven't done our budget before.
[54:32] And they've been thrown into it and I didn't have the level of detail that we need as far as when you get down to the data entry piece and all of the different funding sources and revenue and what's collected on the front end versus what's the back end.
[54:45] I have a decent amount of overview knowledge.
[54:49] I just don't have the specific,
[54:51] why did we get this number here that I have a general idea,
[54:55] but anyway, so we're working hard on it
[55:00] and we should be done, I'm hoping by the end of this week,
[55:04] so for it to submit it.
[55:06] So, and then we'll have our review with Becky and go over those.
[55:11] We've had a few challenges, as we kind of go along the way with our new process in Tyler it's going to be so slick once we have it ironed out.
[55:22] I look forward the next year because this is going to be so much easier to do once we have everything kind of tweaked than the old process.
[55:31] It's not even going to be close. So, very happy to.
[55:34] That is very good to hear. Is it not good?
[55:37] it is. Well in our budget is still complex so I expected this year to be a mass. Because in some
[55:44] of the titles of the line items have changed and then I said we need to create like a chart of
[55:49] accounts so we say okay what goes in these revenue lines what goes in these expense lines just
[55:54] to get more organized and coordinated and we are going to start our budgets way early next year because
[55:59] we're not going to get caught in this crunch again. So. Right. Right. So yes. Good year. And then the other
[56:06] thing that I wanted to just talk about is we're talking with the the courts or the court
[56:12] and the DA's office about there's there's some state passed through reimbursement that we can
[56:18] court counsel has already worked with us on getting this some reimbursement for the for the court
[56:25] cases they take through the children's court and so court counsel does our minor guardianships
[56:31] and termination of parental rights.
[56:33] And then the DAs office does all the chips and chips
[56:37] and the truncies and all those kinds of things.
[56:39] And so both the court and the DAs office
[56:42] can also take advantage of this if they choose to get
[56:46] to pull this reimbursement down because the DAs office
[56:49] does a lot more children's cases than what Corp Council does.
[56:52] So there'd be a lot more money on the table
[56:54] that we could bring in instead of paying lovey for that.
[56:58] So, I think that's really important, and I don't think we've done, I don't, I think Corp Council did maybe last time,
[57:06] but I don't know if the days of the court have done that before, maybe they just didn't know, I don't know,
[57:11] but it's passed through money that we, they would give us the budget we'd submit it, and then it would just flow through,
[57:17] if they had just have to track their time that they spend on kids' cases. So, it's, it's, it's really,
[57:24] as a taxpayer in Trump locality. I like to see those kinds of things.
[57:31] Anything else on budgets?
[57:35] Rockin' along on those?
[57:36] I did want to tell you that we are having six times a year.
[57:40] We have our all-staff meetings, our departmental all-staff meetings.
[57:42] We have our next one this Thursday. They all fire me up.
[57:46] I think a lot of staff can fire up too.
[57:48] But we're going to probably use our November meeting
[57:51] to do some kind of a holiday gathering.
[57:53] So I'll let you know kind of what we decide to do.
[57:56] It's, it's always fun to do something different.
[57:59] And sometimes we've done like tailgate parties and things like that.
[58:02] Broughts out in the courtyard or something like that.
[58:04] So we're going to figure out something fun and something where we can recognize people
[58:08] and then give people a little bit of time to do some things where we kind of do some team building.
[58:16] So yeah, the last thing I have on my list is that the October meeting,
[58:21] I'm going to be gone for that.
[58:22] So Trisha is going to be standing in for me.
[58:26] We're going to be my younger one is in Ireland studying and so we're going to go visit her and then go to Scotland, so yeah.
[58:36] I got another suitcase.
[58:40] That's all I have.
[58:42] All right.
[58:42] I am going to close the public comment period.
[58:46] Let's be official.
[58:49] And like day set, our next meeting will be October 12th at 530, and I'm going to leave the meeting open.
[59:00] We'll all come back in here and adjourn the meeting after we take the tour.
[59:06] So, but if there's anybody that has already seen the Human Services Health Department,
[59:12] And they don't want their need of tour, feel free to adjourn yourself from the meeting.