Packet

September 16, 2026 Health & Human Services Board Agenda SEPTEMBER 16, 2026 HHS AGENDA.PDF September 16, 2026 Health & Human Services Board Packet SEPTEMBER 16, 2026 HHS PACKET.PDF 1. Documents: 2. Documents: Health and Human Services Board MEETING NOTICE Wednesday, September 16, 2026 2:00 PM County Board Room 114 Walworth County Government Center 100 W. Walworth St., Elkhorn, Wisconsin Kenneth Monroe, Chair Kathy Ingersoll, Vice-Chair Supervisor Brian Holt Supervisor Joesph Schaefer Supervisor Tyler Schneider Judy Atkinson - Citizen Representative Monica Los - Citizen Representative Dr. Christopher Tanner – Citizen Representative William Wucherer – Citizen Representative (Posted in compliance with Sec. 19.84 Wis. Stats.) A quorum of the Lakeland Health Care Center Board of Trustees, Human Resources Committee and Children with Disabilities Education Board will be in attendance. It is possible that a quorum of the County Board or any of its other committees could be in attendance at this meeting. Agenda enclosures are available upon request from the County Administrator’s Office or on the County’s web page (www.co.walworth.wi.us). A G E N D A Note: all agenda items are subject to action. 1. Call to order 2. Roll call of committee members 3. Agenda withdrawals, if any 4. Agenda approval 5. Approval of Minutes a) July 22, 2026 Health and Human Services Board Meeting (encl. pp. 3-4) 6. Public Comment Period NOTICE: THIS MEETING IS PLANNED TO PROVIDE FOR REMOTE OR OFF -SITE ATTENDANCE BY COMMITTEE MEMBERS. THE PUBLIC CAN WATCH THE MEETING STREAMING LIVE: https://bit.ly/HHSSept26 Individuals wanting to provide a Public Comment can do so remotely by telephone but must contact the County Administrator’s Office at 262-741-4357 on the day of the meeting and at least 15 minutes prior to the start of the meeting to obtain instructions. AGENDA – Walworth County Health and Human Services Board Wednesday, September 16, 2026 at 2:00 PM Page 2 of 2 7. Public Hearing – The Walworth County Department of Health and Human Services will conduct a public hearing to seek input from consumers of services, consumer family members, and the public. Testimonials will be received on the quality of health and human services programs, unmet needs, and improvements to the current system of health and human services in Walworth County. 8. New Business a) 2027 Health and Human Service Budget Presentation (encl. pp. 5-17) b) Res. No. **-10/26 Authorizing the Elimination of a 0.50 FTE Court Services Specialist Position in the Health & Human Services Department (encl. pp. 18-20) c) Request to Apply for the Brighter Futures Initiative Grant (encl. pp. 21-22) d) Sawyer County Res. No. 2026-32 - Requesting the State to Provide GPR Funding to Cover the Full Non-Federal Share of MA CSP and Crisis Services (To be referred to the Health and Human Services Board) (encl. pp. 23-26) 9. Reports a) Moraine Lakes Consortium’s 2026 Management Evaluation Review (MER) Findings Report (encl. pp. 27-34) b) Maternal Child Health Site Visit (encl. pp. 35-39) c) Birth to Three Determination Status Report (encl. pp. 40-46) 10. Correspondence 11. Announcements 12. Set/confirm next meeting date and time – Wednesday, October 21, 2026 at 2:00 p.m. 13. Adjournment Submitted by: Ken Monroe – Board Chairperson Carlo Nevicosi – Director Posted: September 10, 2026 Health and Human Services | 1910 County Road NN | PO Box 1005 | Elkhorn, WI 53121 www.co.walworth.wi.us | (262) 741-3200 (o) | (262) 741-3217 (f) Memorandum To: Health and Human Services Board CC: Mark Luberda, County Administrator From: Carlo Nevicosi, Director – Health and Human Services Date: September 9, 2026 RE: September 16, 2026 Health & Human Services Board Meeting ______________________________________________________________________________ The Health & Human Services Board meeting agenda includes the following items: ➢ We will be holding our annual public hearing. The public hearing is held to seek input from services recipients, family members and the public on the proposed Health and Human Services budget. ➢ 2027 Health and Human Services Budget Presentation We will provide a detailed presentation covering the proposed 2027 HHS budget. ➢ Res. No. ** -10/26 Authorizing the Elimination of a 0.50 FTE Court Services Specialist Position in the Health & Human Services Department We are requesting the early elimination of this position to help facilitate the transfer of current staff into a vacant 1.0 FTE Court Services Specialist. This item also appears on the Human Resources Agenda ➢ Request to Apply for the Brighter Futures Initiative Grant We are seeking your authorization to apply for a new Department of Children and Families grant. ➢ Sawyer County Res. No. 2026 -32 - Requesting the State to Provide GPR Funding to Cover the Full Non-Federal Share of MA CSP and Crisis Services (To be referred to the Health and Human Services Board ) Received from Sawyer County, this resolution is included in your packet. We will provide some context and a recommendation. Page 1 of 46 ➢ Moraine Lakes Consortium’s 2026 Management Evaluation Review (MER) Findings Report Included in your packet is information regarding our 2026 FoodShare Management Review Evaluation. We will discuss the relevant findings. ➢ Maternal Child Health Site Visit We’ll discuss the findings from our recent Title V MCH site visit. ➢ Birth to Three Determination Status Report Our Birth-to-Three program recently received its annual determination status from the Wisconsin Department of Health Services. We will be discussing our results and the factors that contribute to a status. Page 2 of 46 DRAFT Walworth County Board of Supervisors H ealth and Human Services Board Meeting Minutes Wednesday, July 22, 2026 Walworth County Government Center, County Board Room 114 100 West Walworth Street, Elkhorn, Wisconsin Chair Kenneth Monroe called the meeting to order at 2:00 p.m. R oll call was conducted and the following members were present: Chair Kenneth Monroe; Vice- Chair Kathy Ingersoll; Supervisors Brian Holt, Joseph Schaefer (Remote), and Tyler Schneider; Citizen Representatives: Judy Atkinson, Monica Los (Remote), Dr. Christopher Tanner, and William Wucherer. A quorum was declared. O thers in Attendance County Staff: Walworth County Administrator Mark W. Luberda; Director-Health and Human Services (HHS)/Superintendent of County Institutions Carlo Nevicosi (Remote); Deputy Director Alicia VanDyke; and Behavioral Health Division Manager Amy Hart On motion by Supervisor Holt, second by Supervisor Schaefer, the agenda was approved with no withdrawals. On motion by Vice-Chair Ingersoll, second by Supervisor Schneider, the June 17, 2026 Health and Human Services Board meeting minutes were approved. P ublic Comment – There was none. U nfinished Business 7a. 2027 Budget Ideas or Considerations - Including a Discussion on County Engagement with Homelessness Issue Director-Health and Human Services (HHS)/Superintendent of County Institutions Carlo Nevicosi stated this item is on the agenda as an opportunity for Board members to ask questions and provide input into the 2027 budget. Nevicosi referenced and discussed his Memorandum, included on Pages 6-8 of the packet. The Memorandum contained survey information from neighboring counties on their homelessness efforts; and potential strategies for Walworth County to consider in their efforts with the homelessness issue. He will work with the HHS Chair to learn more about how the legal authority and statutory boundaries for counties are related to shelter operations. Ne w Business 8a. Wood County Res. No. 26-6-1 – Supporting Sustainable State Funding for Local Public Health (To be referred to the Health and Human Services Board) Deputy Director Alicia VanDyke referred to and provided details of his Memorandum and a resolution from Wood County, included on Pages 9-11 of the packet. Supervisor Holt offered a motion, second by Citizen Representative Wucherer, to direct staff to inform the Wisconsin Counties Association (WCA) that they should support Item 8a., the Wood County Res. No. 26-6-1 – Supporting Sustainable State Funding for Local Public Health. Motion carried 9-0. Page 3 of 46 Walworth County Board of Supervisors July 22, 2026 Health and Human Services Board Meeting Minutes Page 2 of 2 8b. Request to Apply for Substance Use Prevention, Treatment, and Recovery Services Block Grant Supplemental Award and Community Mental Health Services Block Grant Supplemental Award Nevicosi referenced and discussed his Memorandum, included on Pages 12-13 of the packet. He explained HHS is requesting authorization to apply for two Wisconsin Department of Health Services grants. HHS was notified of these opportunities on July 6 th, and the grants have a deadline of July 17th. Supervisor Holt offered a motion, second by Citizen Representative Dr. Tanner, to approve Item 8b., the Request to Apply for Substance Use Prevention, Treatment, and Recovery Services Block Grant Supplemental Award and Community Mental Health Services Block Grant Supplemental Award. Motion carried 9-0. Re ports 9a. Behavioral Health Annual Division Presentation Behavioral Health Division Manager Amy Hart presented the Behavioral Health Division Annual Presentation included on Pages 14-20 of the packet covering: Mental Health Statistics; Continuum of Care; Walworth County Residents served; Crisis Services; Outpatient Services; Case Management Services; Collaborations; Outcomes; and Testimonials. Hart presented a video of testimonials of people receiving Behavioral Health Division services. 9 b. Emergency Response Update Nevicosi referenced and discussed his Memorandum, included on Page 21 of the packet, discussing how the Walworth County Room of the Health & Human Services (HHS) building was used as a reception center/shelter following severe storm activity and widespread power loss on July 3 rd. HHS partnered with the Red Cross who primarily staffed the shelter. C orrespondence – There was none. A nnouncements – There were none. U pcoming Events – There was none. C onfirmation of next meeting date and time: The next meeting was confirmed for Wednesday, September 16, 2026 at 2:00 p.m. A djournment On motion and second by Citizen Representative Dr. Tanner and Supervisor Holt, Chair Monroe adjourned the meeting at 2:59 p.m. _________________________________________________________________________________ Submitted by Kathleen Aukland, Administrative Assistant. Meeting minutes are not considered final until approved by the Health and Human Services Board at the next regularly scheduled meeting. Page 4 of 46 Walworth County Department of Health & Human Services Proposed 2027 Budget Adapt, Innovate, Serve 1 2027 Budget Goals Reduce FTE & Maintain Service Levels Identify New Revenues Limit Risk in Vulnerable Areas Plan low-cost initiatives for improved service delivery 2 1 2 Page 5 of 46 2027 Priorities • Leadership Development & Employee Engagement • Lead Community Health Improvement Plan • Strategic Plan Implementation • Expand Parents as Teachers programming 3 Strategic Plan 2027-2029 People, Culture and Organizational Excellence Organizational Alignment, Collaboration, & Purposeful Communication Collaborative Systems, Partnerships, & Community Priorities •Meaningful staff recognition •Investing in training & development •Improving processes and finding efficiencies •Partner with HR for recruitment & retention •Strengthen cross-divisional relationships •Build consistent communication structures •Build a shared understanding of agency direction •Engage in Department-wide CQI •Alignment with CHIP priorities •Convent the right partners at the right time •Create shared responsibilities within collaborations 4 3 4 Page 6 of 46 HHS 2026/2027 Budget Comparison 2027 Budget Year 2026 Adopted 2027 Administrator Budget Increase (Decrease) % Revenues $ 18,991,054 $ 19,158,474 $ 167,420 0.88% Payroll $ 21,720,001 $ 22,081,859 $ 361,858 1.67% Client/Residential $ 4,508,065 $ 4,417,024 $ (91,041) -2.02% Other Expenses $ 5,892,678 $ 6,732,658 $ 839,980 14.25% Use of Fund Balance $ 0 $ 397,491 $ 397,491 0% Initial Appropriation $ 13,129,690 $ 13,675,576 $ 545,886 4.16% Percentage Appropriation 40.88% 41.15% Sheriff 48.8% HHS 20.5% CDEB 9.2% DPW 12.4% LHCC 2.8% All Other 6.4% Walworth County 2026 Tax Levy to Department 5 2027 Budget Overview PERSONNEL REVENUE CHANGES REDUCED EXPENSES COST INCREASES • Eliminate 3.8 FTE B3 • Eliminate .50 FTE Court Specialist • Eliminate 1.0 FTE Reception • Addition of 1.75 FTE Economic Support • MH Navigator Proposal • $629,000 grant revenue increase • $484,000 Medicaid decrease • WIMCR Increase • $449,000 payroll Savings • Reduction in Psychologist contract • Elimination of $20,000 FFCM contract • $361,858 Payroll Increase • 10% Inpatient rate increase • $350,000 Birth to 3 Contract 6 5 6 Page 7 of 46 2027 Revenues Revenues 2026 % 2027 % Federal / State Grants $ 12,190,992 37.95% $ 12,834,214 38.62% Other $ 6,800,062 21.17% $ 6,324,260 19.04% Use of Fund Balance $ - 0.00% $ 397,491 1.20% Tax Levy $ 13,129,690 40.88% $ 13,675,576 41.15% Total $ 32,120,744 100% $ 33,231,541 100% 7 2027 Revenues: Notable Changes Federal / State Grants: Net 2027 increase of $628,928 •SNAP Quality Assurance Funding: $172,190 (new State program) •TAD Grant for OWI Court: $136,621 (transferred from COC) •Children's Long-Term Support CLTS: $51,000 (supplemental/exceptional foster care rates) •Kinship Care Benefits: $45,000 •Supported Housing: $39,643 •ESS Fraud: $18,612 •WIMCR: $50,000 •Home Delivered Meals: $59,710 •Congregate Meals: ($43,989) •FIT Families: ($19,459) - program elimination 8 7 8 Page 8 of 46 2027 Revenues: Notable Changes Other/Insurance Revenues: Net 2027 decrease of $475,802 •Birth to Three Therapy Services: ($131,502) - transition to contracted service •Comprehensive Community Services CCS: ($283,229) • Right sizing for the CRS to CCS Residential transition which was overestimated for the volume of billable hours provided to clients in residential placements • Increasing number of clients clinically needing service but not Medicaid eligible •Crisis Intervention: ($93,095) • Declining reimbursement for services since State's Medicaid restructuring in 2024 • Community Crisis Liaisons (CCLs) billable services lower than expected based on how they support municipalities •Outpatient Clinic: $86,510 • Better workflow for documentation and processing of billable services in Netsmart 9 Wisconsin Medicaid Cost Reporting (WiMCR) 2020 2021 2022 2023 2024 2025 2026 2027 WIMCR Received $754,807 $719,715 $780,184 $944,625 $1,171,629 $1,050,120 Revenue Budget $490,000 $490,000 $450,000 $450,000 $580,000 $650,000 $700,000 $750,000 $- $200,000 $400,000 $600,000 $800,000 $1,000,000 $1,200,000 $1,400,000 10 9 10 Page 9 of 46 Payroll Savings – Wage Roll up *2026 Budget included $345,000 in payroll savings *2027 Budget proposal includes savings of $448,961 (2.0%) 2022 2023 2024 2025 2026 2027 Payroll Activity $ 18,814,247 $ 19,356,587 $ 21,061,959 $ 21,341,198 $ 22,077,381 $ 22,530,820 Savings Included in Budget $ (195,000) $ (387,139) $ (325,000) $ (335,000) $ (345,000) $ (448,961) Adopted Payroll $ 18,619,247 $ 18,969,448 $ 20,736,959 $ 21,006,198 $ 21,732,381 $ 22,081,859 Revised Budget $ 18,517,760 $ 19,241,078 $ 20,895,313 $ 21,293,058 $ 21,749,165 Actual/Projected Payroll Exp $ 17,419,899 $ 18,661,844 $ 20,462,533 $ 20,306,744 $ 20,484,680 Payroll Savings $ (1,097,861) $ (579,234) $ (432,780) $ (986,313) $ (1,264,485) Percent of Payroll Activity 6.87% 4.99% 3.60% 6.19% 7.29% 2.00% 11 Child Protective Services Access/IA Workers Total Reports Received Total Reports Screened In Screen-In % State Average 2022 6 657 151 22.98% 30.42% 2023 6 625 129 20.06% 29.23% 2024 6 696 172 24.71% 27.86% 2025 4 863 270 31.29% 26.51% 2026 (to date) 4 570 174 30.53% 25.14% Total OHC New Removals 2022 72 28 2023 70 32 2024 92 46 2025 87 43 2026 75 35 **$480,000 Foster Care budget unchanged for 2027 12 11 12 Page 10 of 46 Residential & Out-of-Home Care Costs 0 $890,672 $947,076 $805,862 $1,157,146 $1,207,181 $925,250 $836,311 $- $200,000 $400,000 $600,000 $800,000 $1,000,000 $1,200,000 $1,400,000 2027 2026 2025 2024 Adult Residential Adopted Actual 0 $1,958,610 $1,304,357 $1,885,880 $1,345,381 $1,493,354 $1,429,765 $1,642,995 $- $500,000 $1,000,000 $1,500,000 $2,000,000 $2,500,000 2027 2026 2025 2024 Child/Adolescent Out-of-Home Care Adopted Actual 13 Inpatient Hospitalizations 1452 1020 1245 967 979 0 200 400 600 800 1000 1200 1400 1600 Days of care 2022 2023 2024 2025 2026 (projected) 130 95 129 136 140 0 20 40 60 80 100 120 140 160 Admissions 2022 2023 2024 2025 2026 (projected) $1,291,680 $1,297,025 $1,235,935 $1,311,682 $1,247,053 $1,098,673 $899,417 $1,006,369 $1,024,923 $960,432 $1,330,522 $0 $200,000 $400,000 $600,000 $800,000 $1,000,000 $1,200,000 $1,400,000 2027 Budget 2026 Proj 2026 Budget 2025 Exp 2025 Budget 2024 Exp 2024 Budget 2023 Exp 2023 Budget 2022 Exp 2022 Budget INPATIENT Inpatient Base Budget Inpatient Contingent Inpatient Actual Spent 2027 State Institute Rate - $1,931/day (57% increase since 2021) 14 13 14 Page 11 of 46 Senior Support Services 2027 Levy Impact - $137,921 Caregiver Support Program/Respite Care Budget Year # of Clients Served # of Clients on Waitlist Grant Funding Revenue Levy Funding Total Budget 2027 (budgeted) 60 40 $ 41,353 $ 0 $ 97,569 $ 138,922 2026 (adopted) 55 50 $ 59,481 $ 0 $ 44,517 $ 103,998 2026 (projected) 58 35 $ 76,300 $ 0 $ 11,490 $ 87,790 2025 49 48 $ 46,314 $ 0 $ 43,473 $ 89,787 2024 30 60 $ 48,637 $ 0 $ 20,046 $ 68,683 Supportive Home Care Budget Year # of Clients Served # of Clients on Waitlist Grant Funding Revenue Levy Funding Total Budget 2027 (budgeted) 55 65 $ 99,315 $ 0 $ 40,352 $ 139,667 2026 (adopted) 60 58 $ 126,421 $ 0 $ 22,409 $ 148,830 2026 (projected) 58 60 $ 117,441 $ 0 $ 20,937 $ 138,378 2025 53 51 $ 90,254 $ 0 $ 46,238 $ 136,492 2024 40 88 $ 94,332 $ 0 $ 23,541 $ 117,873 15 Home Delivered Meals Budget Year # of Clients Served # of Clients on Waitlist Grant Funding Revenue Levy Funding Total Budget 2027 (budgeted) 325 0 $ 147,023 $ 63,000 $ 298,878 $ 508,901 2026 (adopted) 300 0 $ 87,313 $ 60,000 $ 282,738 $ 430,051 2026 (projected) 300 0 $ 137,564 $ 65,843 $ 209,741 $ 413,148 2025 295 3 $ 166,525 $ 62,142 $ 192,948 $ 421,615 2024 242 22 $ 153,021 $ 60,101 $ 141,992 $ 355,114 Congregate Meals Budget Year # of Clients Served # of Clients on Waitlist Grant Funding Revenue Levy Funding Total Budget 2027 (budgeted) 260 0 $ 185,519 $ 36,000 $ 134,109 $ 355,628 2026 (adopted) 230 0 $ 239,508 $ 27,600 $ 132,518 $ 399,626 2026 (projected) 250 0 $ 173,748 $ 35,735 $ 106,967 $ 316,450 2025 229 0 $ 266,287 $ 35,124 $ 5,829 $ 307,240 2024 201 0 $ 178,688 $ 26,224 $ 82,333 $ 253,572 Senior Nutrition Program 2027 Levy Impact - $432,987 16 Home Delivered • 41,500 Meals Congregate • 17,000 Meals • Quarterly Pop-Up Sites Pop-up sites serve an average of 40 participants 15 16 Page 12 of 46 New In 2027 CO NT INGE NCY B UIL DING CR ISIS L E L IAISO N SUSTAINAB IL IT Y FAMILY FO UNDAT IO NS HO ME V ISIT ING GR ANT MH DIV E RSIO N P RO GR AM W H IT E WAT E R MH NAV IGATO R 17 Contingency Planning County Contingency Fund: Youth Corrections •Sliding scale based on annual State rates •Funded with year-end budget savings •7/1/2026 rates are $758/day or $276,670 annually •Expecting significant future increases Concern: HHS does not have control over these placements or costs & is statutorily required to pay for it Benefit: The potential cost impact is not directly included in the annual operating budget HHS Residential Contingency Pilot •$582,822 new residential placements budgeted in a contingency transfer account ◦ Behavioral Health - $123,441 ◦ Family Wellness - $459,381 •Committee/Board action needed for budget transfer Concern: HHS has more control, but is seeing increasing client needs and facility costs Benefit: Included in the operating budget, but Director has added oversight on new residential placement decisions Option: Future opportunity for another County Contingency Fund 18 17 18 Page 13 of 46 Crisis Law Enforcement Liaisons & Sustainability Supervisor CCL Whitewater CCL Delavan CCL Lake Geneva CCL Sheriff's Office CCL Case Manager 2027 Goals ▪Maximize revenues ▪Identify new grants ▪Explore cost sharing ▪Plan for possible contraction 19 Family Foundations Home Visiting Grant 20 • Early Home Visiting Services are currently offered through four different program areas using several approaches: • Family Wellness Ongoing • Functional Family Therapy • Birth to 3 • Public Health Nursing • The FFHV Grant provides funding and technical assistance to bring the services together, applying one of five federally-approved approaches. • Parents as Teachers (PAT) emerged as a best-fit. If awarded, FFHV provides $200,000 annually for up to 10 years 19 20 Page 14 of 46 Mental Health Diversion Purpose: • Redirect those with mental health conditions away from criminal prosecution • Reduce the cycle of incarceration by addressing root cause behavior • Decrease mental health crises in the jail How It Works: • Eligibility based on clinical diagnosis and offense • Enrollment in mental health treatment program • Utilizes existing Behavioral Health programs • Completion results in reduced penalties Benefits: • Decreased recidivism and improved long-term stability • Right service/right setting • Decreased costs: • Fewer charges incurred in the jail • Decreased jail census • Reduction of time spent in court 21 Mental Health Navigators Career & College Academy Elkhorn Area School District Whitewater School District Funding 75% EASD, 25% Opioid Settlement Funding 75% EASD, 25% WCDHHS Opioid Settlement Funding 50% WWSD, 50% Opioid Settlement Duties • Behavioral Health screening & prevention • Crisis intervention & treatment • Referrals, home visits • Treatment groups • Independent living skills • Municipal Court Program Duties • Behavioral Health screening & prevention • Crisis Intervention and Treatment • Referrals, home visits • Treatment groups • Municipal Court Program • Staff training Duties • Behavioral Health screening & prevention • Crisis Intervention and Treatment • Referrals, home visits • Treatment groups • Municipal Court Program • Staff training 22 21 22 Page 15 of 46 Opioid Initiatives 2 0 2 7 P RO P O S E D O P I O I D B U D G E T - $ 6 8 5 , 0 1 5 P ROJ E C T E D 2 0 2 6 E N D I N G O P I O I D BA L A N C E- $ 2 , 3 8 7 , 8 3 9 Credible Mind MH Navigator Whitewater Youth Resiliency Programming Youth Residential Placement Recovery Housing Medications 23 Opioid Settlement Funding **Above information does not include Purdue Bankruptcy ($1.5 billion) or Sackler Settlement ($6.5 billion) 24 23 24 Page 16 of 46 Thank you! 25 Page 17 of 46 Health and Human Services | 1910 County Road NN | PO Box 1005 | Elkhorn, WI 53121 www.co.walworth.wi.us | (262) 741-3200 (o) | (262) 741-3217 (f) Memorandum To: Human Resources Committee Health & Human Services Board From: Carlo Nevicosi, Director Date: August 26, 2026 RE: Res. No. **10/26 Authorizing the Elimination of a 0.50 FTE Court Services Specialist Position in the Health & Human Services Department ______________________________________________________________________________ The 2027 proposed Health & Human Services budget includes the elimination of position 210827 - 0.50 FTE Court Services Specialist. In response to a proposed restructuring of roles and responsibilities, Health and Human Services intends to reduce the FTE dedicated to this program area by eliminating the .50 FTE Court Services Specialist position and transitioning the current occupant i nto the vacant 1.0 FTE Court Services Specialist position, which will be retained. This early implementation of this planned position elimination will facilitate the transfer of the current employee and ensure adequate staff capacity is available to support the restructured approach in this program area going forward. The net effect of this early implementation is to reduce the FTE count for the Court Services program from 1.50 FTE down to 1.0 FTE, which will adjust the Health & Human Services FTE count and reflect a wage & benefit savings of $9,332 for the remainder of 2026 and a savings of $47,983 annually as included in the 2027 proposed budget. Page 18 of 46 1 Resolution No. xx-10/26 Authorizing the Elimination of a 0.50 FTE Court Services Specialist Position in the Health & Human Services Department M oved/Sponsored by: Health and Human Services Board and Human Resource Committee 1 2 WHEREAS, there are currently 1.50 FTE Court Services Specialist positions in the Health & 3 Human Services Department; and, 4 5 WHEREAS, management at Health & Human Services is proposing a restructure of roles and 6 responsibilities of staff and seeks to transition the current employee in the part-time Court 7 Services Specialist position into the vacant full-time Court Services Specialist position and 8 eliminate the part-time 0.50 FTE Court Services Specialist position; and, 9 10 WHEREAS, the Human Resources Committee (“Committee”) has considered the elimination of 11 the 0.50 FTE Court Services Specialist position and hereby recommends the elimination. 12 13 NOW, THEREFORE, BE IT RESOLVED by the Walworth County Board of Supervisors that 14 the elimination of the 0.50 FTE Court Services Specialist position be and the same is hereby 15 approved effective as of October 19, 2026. 16 17 BE IT FURTHER RESOLVED that the County Administrator shall update the appropriate 18 Administrative Procedure to reflect the new FTE count of 1.00 FTE Court Services Specialist 19 position, 196.195 Total Health & Human Services FTEs, with the Grand Total County FTEs 20 being adjusted accordingly for the overall 0.50 FTE decrease. 21 22 23 24 25 Rick Stacey Susi Pike 26 County Board Chair County Clerk 27 28 County Board Meeting Date: October 13, 2026 29 30 Action Required: Majority Vote X Two-thirds Vote Other ______ 31 Policy and Fiscal Note is attached. Reviewed and approved pursuant to Section 2-91 of the Walworth County Code of Ordinances: Michael P. Cotter Date Jessica Conley Date Corporation Counsel Finance Director Mark W. Luberda Date County Administrator I f unsigned, exceptions shall be so noted by the County Administrator. Page 19 of 46 2 Policy and Fiscal Note Resolution No. xx-10/26 I. Title: Authorizing the Elimination of a 0.50 FTE Court Services Specialist Position in the Health & Human Services Department II. Purpose and Policy Impact Statement: The purpose of the resolution is to eliminate the 0.50 FTE Court Services Specialist position at HHS. III. Budget and Fiscal Impact: The passage of this resolution eliminating the 0.50 FTE Court Services Specialist position will result in a savings of $9,332 for the remainder of 2026 and a savings of $47,983 annually as included in the 2027 proposed budget. IV. Referred to the following standing committees for consideration and date of referral: Committee: Health & Human Services Board Date: September 16, 2026 V ote: C ommittee: Human Resources Committee Date: September 16, 2026 V ote: C ounty Board Meeting Date: October 13, 2026 Policy and fiscal note has been reviewed and approved as an accurate statement of the probable policy and fiscal impacts associated with passage of the attached resolution. Michael P. Cotter Date Jessica Conley Date Corporation Counsel Finance Director Mark W. Luberda Date County Administrator Page 20 of 46 Health and Human Services | 1910 County Road NN | PO Box 1005 | Elkhorn, WI 53121 www.co.walworth.wi.us | (262) 741-3200 (o) | (262) 741-3217 (f) Memorandum To: Health & Human Services Board From: Carlo Nevicosi, Director Date: September 9, 2026 RE: Request to Apply for the Brighter Futures Initiative Grant ______________________________________________________________________________ W e are requesting authorization to submit a grant application to the Wisconsin Department of Children and Families (DCF) for the Brighter Futures Initiative Grant. The Brighter Futures Initiative supports innovative strategies that reduce risk factors, build resiliency, and strengthen long-term outcomes for youth and families. We plan to request $150,000, with grant awards providing three years of funding and the potential for two additional renewal years. The initiative requires a 25% local match. Our 2027 budget proposal includes the creation of a Mental Health Navigator assigned to the Whitewater School District. The current plan funds 50% of this position through Opioid Settlement dollars, with Whitewater committing the remaining 50%. Whitewater’s contribution is contingent upon securing its own grant funding. Applying to Brighter Futures provides an alternative path to sustain the position if Whitewater is unable to obtain those funds. Whitewater was selected due to demonstrated need within the district including: • Twelve Youth Justice referrals last year • A decline in graduation rates from 95% in 2021 to 90% in 2024 • A three-year chronic absenteeism rate of 29.9% • Nearly half of students (47.8%) classified as economically disadvantaged • Elevated rates of Child Protective Services involvement within the city Page 21 of 46 The proposed school-based Mental Health Navigator would mirror our successful model operating within the Elkhorn Area School District. Core responsibilities would include behavioral health screenings, crisis intervention, treatment support, linkage to community resources, home visits, staff consultation and training, and leadership of Municipal Court Program services within Whitewater. Authorization to apply for this grant will allow us to pursue a viable funding avenue to support a high- impact position designed to improve safety, stability, and long- term outcomes for Whitewater youth and families. Page 22 of 46 Page 23 of 46 Page 24 of 46 Page 25 of 46 Page 26 of 46 dhs.wisconsin.gov Tony Evers Governor Kirsten L. Johnson Secretary S tate of Wisconsin Department of Health Services Division of Medicaid Services 201 E. Washington Ave. PO Box 309 Madison, WI 53701-0309 Phone: 608-266-8922 Fax: 608-266-1096 TTY: 711 June 23, 2026 H eather Merten Income Maintenance Operational Lead Moraine Lakes Consortium R E: 2026 Management Evaluation (ME) Review D ear Heather, T hank you for providing Moraine Lakes Consortium responses to the corrective action and element reviewed sections on its final MER Findings Report. The Consortium’s responses have been reviewed and are sufficient to close the 2026 FoodShare Management Evaluation Review. I would like to thank you and all staff for your cooperation, flexibility, and assistance during the review process. I f you have any questions, concerns, or other feedback, please feel free to email DHSFoodShareME@dhs.wisconsin.gov, or contact me directly by email below. H ave a wonderful day! R espectfully, Kris Bovee Kris Bovee Management Evaluation Review Coordinator Division of Medicaid Services | Dept. of Health Services 608.422.2828 kristine.bovee@dhs.wisconsin.gov cc: Jonelle Brom, DHS Director, Bureau of Eligibility, Operations, and Training Katie Sepnieski, DHS Deputy Director, Bureau of Eligibility, Operations, and Training LaTanya Taylor, DHS Section Manager, Eligibility Quality Control Vanessa Robertson, DHS Eligibility Quality Control Mia Anderson-Inman, Alternate IM Consortia Operational contact Page 27 of 46 Moraine Lakes Management Evaluation Review (MER) Findings 2026 Page 1 of 7 Overview The State of Wisconsin conducts Management Evaluation (ME) Reviews to evaluate the administration of the FoodShare (FS) program, federally known as the Supplemental Nutrition Assistance Program (SNAP). In accordance with Federal Regulations 7 CFER 275.5 and 275.5(b)(2): • Each State agency shall ensure that project areas operate SNAP in accordance with the Act, Regulations, and FNS-approved State Plan of Operations. • States must conduct ME reviews for the State target areas, defined annually by FNS, in accordance with the following schedule, or on a more frequent basis if there is an identified risk: o In large project areas every year o In medium project areas every 2 years o In small project areas every 3 years Wisconsin’s project areas consist of: • 10 consortia and Milwaukee Enrollment Services, which are large areas reviewed annually • 9 Tribal agencies, which are small areas reviewed triennially, or more frequently if a risk is identified Objectives The ME Review process is designed to provide an overall picture of the agency or consortium’s effective and accurate administration of the FoodShare program in compliance with federal guidelines, as well as to identify areas that could be improved. The objectives of the ME review are to: • Provide a systematic method of monitoring and assessing the FoodShare program administration in the project areas • Provide a basis for project areas to improve and strengthen program operations by identifying and correcting deficiencies • Provide a continuing flow of information between Income Maintenance (IM) agencies, state agencies, and Food and Nutrition Services (FNS), as needed to develop the solutions to problems in program policy and procedures Target areas Each year FNS designates target areas to focus on for the ME Review. This year’s FNS target areas are: • Certification Processes and Program Access • Able-Bodied Adults Without Dependents (ABAWD) Time Limits and Work Requirements Wisconsin has chosen to also review these at-risk areas: • Six-Month Reporting (SMRF) Timeliness & Break in Service • SNAP-Ed Educational Components • Annual Mandatory Training Page 28 of 46 Moraine Lakes Management Evaluation Review (MER) Findings 2026 Page 2 of 7 Elements Reviewed, Methodology and Tools The ME Review activities will consist of observation and analysis of agency functionality and case accuracy. Findings and results are compiled, shared, and discussed at the Entrance Meeting conference. Any corrective actions and/or recommendations are addressed below in the respective areas of this report. Assessment tools used and elements reviewed may include: • Active Payment and Case and Procedural Error (CAPER) rates • Review of FoodShare error letters • FoodShare certification case file reviews • Six Month Report Timeliness case file reviews • Anonymous calls and customer Call Quality Reviews • Agency website reviews • Lobby visits and observations • Annual mandatory training records • EBT Log submittal and review of EBT card issuance • Customer, Advocate, and Staff Survey responses and feedback forms submitted Report format and Findings This report includes findings and recommendations that were derived from data and observations compiled using the tools listed above, and is presented in the following sections: A. Elements Reviewed: This section requires an agency response within 30 days – see below. B. Findings with Corrective Actions: Each finding listed in this section requires an agency response within 30 days – see Required Follow Up Actions section below. C. Findings with Recommendations: These findings have recommended agency actions listed. Agency responses are not required for these findings; however, agencies may include additional responses, if they wish to do so. D. Best Practices Identified: This section lists both: • Observed past and/or current agency practices which are commendable • Suggested practices that the agency could adopt to improve its effectiveness Required Follow Up Action(s) needed from agencies Within 30 days of receiving this report, please return it with your agency’s responses to all Findings detailed in the orange boxes. Agency responses should consist of: ➢ Actions that your agency has taken or will be taking to rectify the findings and corrective actions ➢ Details such as specific course names, and dates by which any training will be completed, etc. ➢ Any other supporting documentation that assists with addressing the finding’s corrective actions All other areas related to the ME review activities conducted that are not mentioned as having a Finding in sections B-C of this report were found to be in compliance with the FoodShare program administrative requirements, policies, and regulations. Page 29 of 46 Moraine Lakes Management Evaluation Review (MER) Findings 2026 Page 3 of 7 Elements Reviewed, Findings, Required Actions, Recommendations, and Best Practices: A. Element Reviewed: Active and Case Procedural Error Rate Improvement Agency Response to Element Reviewed: Please describe all actions that the agency or consortium has taken or will take to reduce its Active Payment errors and Case and Procedural Error Rate (CAPER). Examples may include agency or consortium-wide training or process enhancements, staff review of errors, internal quality assurance reviews, use of the Pre-Certification Review (PCR) Tool, etc. Please provide specific actions taken, methods used, course names, and completion dates, and reference all information that will be shared with staff as part of the ME Review process. Agency Response: Our consortium has increased the usage of the PCR tool since August 2025—this includes adding more staff and increasing the number of slots available to pull cases. We have also lowered the parameters by which a case can be pulled (lower thresholds so more cases are pulled). Additionally, we have instituted reviews of FSQC errors with staff in various capacities such as direct with staff who was found in error, unit meetings, monthly consortia QC meetings. In 3rd quarter 2025 all staff were required to take the following trainings in Cornerstone: IM Refresher Prospective Budgeting, IM Refresher: CAPERS, IM refresher Active Errors. Our consortium continues to do call reviews on call center agents in varying frequencies and sharing common errors and PRT responses to avoid some errors. Review Findings in need of Corrective Action(s): • Certification Processes and Program Access • Able-Bodied Adults Without Dependents (ABAWD) Time Limits and Work Requirements • Six-Month Reporting (SMRF) reporting timelines & Break in Service Agency Responses to Findings in need of Corrective Action(s): Finding 1 Upon DHS review of 25 Call Quality Reviews (CQR’s): the FS Reporting Requirements script was not read for all calls with a FS interview conducted. • 2 out of 25 calls did not have the reporting requirement script read as required per policy. • See A2. Call Quality Reviews Agency Response: Our consortium will include this reminder in our 6/10 staff meeting when we talk about effective/quality interviewing. During this session we also plan to talk about the importance of open-ended questions, reading all scripts, asking all gatepost questions, all topics that should be discussed with members and clear case comments. Our consortium will continue to do call reviews on call Required Action for Finding 1: The Reporting Requirements Call Script OM 25-09 Attachment is required to be read during all FS interviews, per policy Policy References: FoodShare Handbook: - 2.1.3.2 Completing the Interview Page 30 of 46 Moraine Lakes Management Evaluation Review (MER) Findings 2026 Page 4 of 7 - 2.1.3.2.1 Required Interview Topics - FoodShare Reporting Requirements Call Script for Income Maintenance Agencies (wisconsin.gov) center agents to allow for more direct coaching when scripts are not being read correctly. Finding 2 All FS application methods and the importance of the Filing Date were not always explained to customers expressing food insecurity: • On 2 out of 10 Anonymous calls, staff did not explain all FS application methods • On 3 out of 10 Anonymous calls, staff did not explain the importance of establishing a filing date when applying • See attachment A4. Anonymous Calls Agency Response: Our consortium will include this reminder in our 6/10/26 FSQC focused all-staff meeting when we talk about effective/quality interviewing. During this session we also plan to talk about the importance of open-ended questions, reading all scripts, asking all gatepost questions, all topics that should be discussed with members and clear case comments. Additionally, we are working on a small reference item that can be hung from monitors/taped onto desktops to remind staff to discuss the ways to apply, importance of a filing date and minimum required items to set a filing date—this will be provided to staff. Agencies will provide and review the local agency script available from ops memo 26-01 attachment B with front desk staff who interact with potential applicants by 6/10/26. Required Action for Finding 2: All IM staff who work with customers are required to know and explain the minimum information required to request FS benefits, which includes all ways to apply and the importance of setting the filing date. Staff should attempt to set the filing date on the same day a customer expresses food insecurity. Policy References: FoodShare Handbook: - 2.1.1 Initial Certifications (Applications) DHS DMS Administrator’s Memo Series: - Customer Service: dms-admin-26-01.pdf (wisconsin.gov) - Attachment 2 – Telephone Script Tool for Consortia and Local Agency Use: dms-admin-20- 04attachment2.pdf (wisconsin.gov) Finding 3 FSQC Error Reports show 5 Active and 11 CAPER errors: • Active payment error rate of 7.73%, with errors totaling $1,131 due to: o Wages & Salaries ▪ Agency error of $613 when the agency did not update reported income from an access application and issued expedited benefits in error. When verification was received, income was entered incorrectly. o Child Support Payments Received from Absent Parent ▪ Agency error of $90 due to budgeting child support income that is not available to the household. ▪ Agency error of $218 due to coding child support income incorrectly so that Agency Response: Our IM staff will take all of the following trainings by 7/31/26 • IM Refresher: Active Error Rates • IM Refresher: Case and Procedural Errors (CAPERS) • IM Refresher Training: Prospective Budgeting • The FoodShare Basic Work Rules and FoodShare Work Requirement - Interviewing and Exemptions Page 31 of 46 Moraine Lakes Management Evaluation Review (MER) Findings 2026 Page 5 of 7 it did not count in the foodshare budget as it should. o Standard Utility Allowance ▪ Client error of $151 due to client reporting paying for heat when all utilities are included in the rent and the client only has a phone expense. o Shelter Deduction ▪ Client error of $59 for reporting incorrect property tax and homeowner’s insurance amounts. • CAPER error rate of 25.58%, with errors due to: o Notices: ▪ Unclear notice of decisions received due to incorrect calculation of income, incorrect pay frequency used, and incorrect child support income entered. o Verification: ▪ FS incorrectly denied at application without requesting income verification. o Wages and Salaries: ▪ Income incorrectly counted for a deceased member and for a member that was not currently in the home. o Application: ▪ Application denied prior to 30th day. See Attachments A6. FSQC Errors and A7. FSQC Error Rates • IM Refresher: Effective Interviewing Skills and Case Comments • IM Refresher Training: FoodShare Interview Concepts - Wrapping Up the FoodShare Interview • IM Refresher Training: Interpreting the FoodShare Budget • IM Refresher: Medical coverage On 5/13/26 management held our 1st FSQC monthly all staff in which we discussed correct application of shelter and utility costs, reviewed available resources for looking up property taxes, etc. Agencies will review with staff the time available to review policies, take trainings and how to seek more time when needed. We are certain that the 6/22/26 change in CWW to show 3 months of Foodshare budgets simultaneously will assist staff in reviewing budgets for changes/accuracy. We will continue to utilize the PCR tool and increase the number of cases run through the tool until the 25% of Foodshare applications/renewal value is met. FSQC case errors will be reviewed directly with the staff who were involved in the case at the time of the error. Required Action for Finding 3: DHS recommends that all staff review the FSH and PH chapters referenced below and complete these DMS-BEOT courses in Cornerstone • IM Refresher: Active Error Rates • IM Refresher: Case and Procedural Errors (CAPERS) • IM Refresher Training: Prospective Budgeting • The FoodShare Basic Work Rules and FoodShare Work Requirement - Interviewing and Exemptions • IM Refresher: Effective Interviewing Skills and Case Comments • IM Refresher Training: FoodShare Interview Concepts - Wrapping Up the FoodShare Interview • IM Refresher Training: Interpreting the FoodShare Budget DHS also recommends regular reminders for staff to check the FS Budget and Assistance Group pages before confirming, and preview notices in CWW whenever possible, as best practices for case accuracy and error prevention. In addition, DHS Page 32 of 46 Moraine Lakes Management Evaluation Review (MER) Findings 2026 Page 6 of 7 C. Best Practices observed over the past year and suggested for future years: Observed: Moraine Lakes has provided excellent customer service and accurate benefits – please continue all these practices: ✓ Call Quality Reviews and Customer surveys reflected very good customer service being provided. ✓ Agency lobby was customer-friendly with helpful staff and resources and info available. recommends that all agencies master and utilize the Pre- Certification Review tool, to prevent payment errors, identify error trends, and address training needs. Policy References: FoodShare Handbook - 1.2 Verification - 1.2.7 Unclear Information - 2.1.3 Interviews - 3.16.1 FoodShare Basic Work Rules - 3.17.1 FoodShare Work Requirements for ABAWD’s - 4.1.1 General Financial Eligibility - 4.3 Income - 4.6.7 Shelter and Utility Deductions Process Help: - 4.3 Budgets - 11.5 Prospective Budgeting - 3 Verification - 18.44.2 Pre-Certification Review Tool (PCR) - 6 Member Correspondence - 14.15 ABAWDS B. Review Findings with Recommendations: • Certification Processes and Program Access • Able-Bodied Adults Without Dependents (ABAWD) Time Limits and Work Requirements • SNAP-Ed Educational Components Finding 4 It is recommended that the agency websites be updated to include all four ways to apply and a link for language translation for individuals with Limited English Proficiency. • The Ozaukee and Walworth County websites should be updated to include all four ways to apply. o Currently both websites only list the access website or the call center options. • Several of the county websites should be updated to include a link for language translation for individuals with Limited English Proficiency. o The Waukesha County website has a button, but no languages appear to translate. o The Fond du Lac and Ozaukee County websites should be updated to include this. Recommended Action for Finding 4: Collaborate with technology staff to update your agency’s website to include hyperlinks and a clearer layout. Policy References: - DMS Administrator’s Memo 26-01 Customer Service Page 33 of 46 Moraine Lakes Management Evaluation Review (MER) Findings 2026 Page 7 of 7 ✓ Over 99% of customers indicate they understand how to use their Quest Card, obtain a replacement card, keep their card safe, and protect their PIN number. ✓ 95% of customers feel they receive great service and are treated respectfully, per the Customer Survey results. ✓ 86% of staff feel that adequate time is allocated for completing training and reviewing OM’s. ✓ 94% of staff are aware of the Time Limited Benefits policy changes. ✓ 98% of staff indicated they read the Reporting Requirements and Work Requirements scripts for all interviews, as is required by policy. Suggested: Strengthening commitment to case accuracy and policy compliance: ➢ Review Certification cases and program access policies to ensure solid knowledge in this area and that all customers who express food insecurity are receiving information about all application methods and the importance of setting the filing date. ➢ Implement effective and sustainable internal processes to ensure that all internal work, including EBT card log tracking, inventory, and submittal, case quality assurance checks, overpayment processing, and fraud investigation, etc., can continue during times of staff absences or turnover. ➢ Schedule and allow adequate time for training, reviewing OM’s, and accurate case processing. ➢ Periodically review websites to ensure that all signage and links are current. ➢ Review and follow all policy references in this Findings report. ➢ Implement an internal plan for continuous improvement. Page 34 of 46 dhs.wisconsin.gov T ony Evers Governor Kirsten L. Johnson Secretary State of Wisconsin Department of Health Services Division of Public Health 201 E. Washington Ave. PO Box 2659 Madison, WI 53701-2659 Phone: 608-266-1251 Fax: 608-267-2832 TTY: 711 or 800-947-3529 J uly 27, 2026 H olli Wilki Public Health Supervisor Walworth County Health and Human Services 1910 CR NN Elkhorn, WI 53121 De ar Holli Wilki, Thank you for your time and hospitality during the Title V MCH program site visit conducted on 7/21/2026. The attached report details the results of the site visit that are consistent with the strong administrative leadership and quality of care provided in your community. There are no areas of improvement indicating that Walworth County Health and Human Services complies with all other aspects of the contract and applicable federal regulations and guidance. I would like to thank you and your staff for your hard work, cooperation, and dedication to the Title V MCH program and look forward to our continued partnership. S incerely, T essa Donaldson Child and Adolescent Health Unit Wisconsin Department of Health Services Page 35 of 46 Department of Health Services State of Wisconsin Division of Public Health Page 1 of 4 F-03419 (01/2026) F amily Health Section Site Visit Evaluation Instructions: The Wisconsin (WI) Department of Health Services (DHS) Family Health Section (FHS) Contract Administrators will use this review form to complete the annual site visit for subrecipients. Contract Administrators should fill out the Contract information prior to the site visit. Contract information Program name: Title V MCH Contract administrator: Tessa Donaldson Date of site visit: 7/21/2026 Contract period: 2026 Contract amount: $34,155 Contracted agency: Walworth County Health and Human Services Agency address street: 1910 County Rd NN Agency city: Elkhorn State: WI ZIP code: 53121 Funding source: Title V MCH Agency information Staffing List the names and titles of the staff person(s) responsible for each of the following: Development of the program plan and priorities: Mallory, Holli, and Erica, Collection and evaluation of program data: Holli, Mallory, and Sabrina Preparation and submission of performance reports: Holli and Mallory Recruiting, hiring, and training new staff: Holli, Erica, and Mallory Fiscal tracking and submission of expense reports: Tim Is the agency fully staffed for this program? Yes No If no, what is the agency’s plan to reach full staffing capacity? How is the agency ensuring the service needs of the program are met for any vacancies? If future vacanies occur, they would shift the work until new hire. How many new hires were made for the program during the previous 12 months? none List the positions that were hired: Describe any barriers to hiring staff? Rural location- selection is smaller Have efforts been made to recruit and hire staff with diverse backgrounds? Yes No Describe the agency’s efforts to ensure your workforce reflects the individuals being served: They a intentional about the questions asked in interviews about lived and professional experience. They recruit all throughout Wisconsin and uses social media. Training List the training/education received by the individuals funded through this program within the previous 12 months: Fulfilling the Promise Conference, Collabortive partnership training, Perinatal Depression Training, other sessions online. Subcontractors Page 36 of 46 F-03419 Page 2 of 4 Does the agency use one or more subcontractors on this program? Yes No If “no,” go to the next section. If “yes,” please list their names: Describe the subcontractor monitoring process and how often monitoring occurs: Describe any issues experienced with subcontractor(s) and how the issues were addressed: Does the agency inform its subcontractor(s) of the federal and state requirements for the funding sources used in the contract? Yes No Culturally and linguistically appropriate services (CLAS) Is the agency compliant with the Federal Americans with Disabilities Act? Yes No What services or resources does the agency provide to promote accessibility for individuals who are deaf or hard of hearing, blind, visually impaired, or who have other disabilities? Various tools and signs to help people who come in with disabilities. Working to make website accessible. Are any of the following services available to individuals who are deaf or hard of hearing, blind, visually impaired, or who have other disabilities? Braille documents Sign language services Translator services TTY service Computer-based assistive technology Other, specify: What are the major non-English languages in the service area? Spanish Are translations of written materials available in those languages? Yes No Are interpreter services available in those languages? Yes No Funding source requirements An Affirmative Action and Civil Rights Compliance Plan is required if the agency receives federal funds over $50,000 and has a workforce of 50 or more employees as of the award date of the contract. Does the agency have a plan on file? Yes No N/A It is best practice to have insurance coverage (for the agency’s own protection). The Board of Directors or another responsible party may be held liable for costs if the agency does not maintain coverage. Typical coverage includes general liability (covers bodily injury, property damage), automobile liability (protects agency employees and consumers traveling to/from services using agency vehicles), and workers compensation (provides medical expenses, lost wages, and rehabilitation costs to employees who are injured on the job). Note: This may not be required for State agencies. Does the agency have insurance? Yes No N/A Performance monitoring and quality improvement Scope of work monitoring Is the agency meeting its requirement to submit data and/or reports? Yes No N/A Page 37 of 46 F-03419 Page 3 of 4 If “No”, please describe: Describe the tools and methods used to collect the data for program services and activities: Midyear report, track outreach events, performance management system to track data for all programs Describe the procedures/processes used to evaluate program services and activities: Staff enter into performance management system and managers look through that monthly. Every year when planning they look back at previous years to improve work. Describe any barriers to program evaluation: Dealing with how the work has to shift or does shift throughout the year. Staff turnover. Are program outcomes identified on the Work Plan on track to be completed? Yes No If “no,” please describe: Identify any reports (such as performance reports, final expenditure reports, Cost Tracking Workbooks) that were incomplete or not provided timely: None Financial monitoring What months of expense reports were reviewed? (use MM-YYYY format) 03-2026 and 04-2026 Do the expenses adhere to the grant’s specific terms and conditions? Yes No Do the expenses fall within the approved budget categories? Yes No Do the receipts/reports match the amount reported on the expense report? Yes No If “no,” please describe: Are there concerns with overspending or underspending? Yes No If “yes,” please describe: Additional program requirements This is reserved for additional items specific to this program or agency. It may include items for which the Contract Administrator would like additional information. Example items may include documentation specific to the contract regulatory information, corrective action response plans, recommendations from previous contract years, or other items not covered in the section above. Item 1: In general, explain how your MCH objective (s) are going? a. W hat system changes are you seeing as a result of your work on the MCH Objective(s)? b. D o you need any support from the objective lead or contract administrator to meet your contract requirements? Agency response: PMH - They were successful in building a skillset and working towards improving quality asssurance. AMH: They are still in the planning phase but have already seen better partnerships with schools as a result of the objective. Item 2: Prenatal Care Coordination a. Is yo ur agency currently providing Prenatal Care Coordination (PNCC) services? b. I f yes, are you currently billing or planning to bill for PNCC services? Agency response: Yes, they currently bill Item 3: MCH Program Reminders: Page 38 of 46 F-03419 Page 4 of 4 a. J oin Learning Community Calls live or view recording b. M onthly Fiscal Reporting to GEARS and your contract administrator c. W ell Badger Promotion d. M id year and end of year reporting dates Agency response: Findings and recommendations Identify any additional items to be noted for the site visit: Tessa will follow- up on questions and concerns that were noted during the site visit. Identify the positive findings from the site visit: Walworth County is doing a great job implementing the AMH and PMH objectives. Identify the corrective action response findings from the site visit: None Summarize recommendations based on the site visit: Keep up the great work! S ignature — Contract administrator: Name — Contract administrator (printed): Tessa Donaldson Date signed: 07/23/2026 Page 39 of 46 Tony Evers Governor DIVISION OF MEDICAID SERVICES 201 E Washington Avenue MADISON WI 53701-0309 Kirsten L. Johnson Secretary State of Wisconsin Telephone: 608-266-8922 Fax: 608-266-1096 TTY: 711 Department of Health Services www.dhs.wisconsin.gov Date: July 8, 2026 To: Alison Mansky, Birth to 3 Program Administrator Walworth County Birth to 3 Program From: Deborah Rathermel, Director Bureau of Children’s Services Re: DETERMINATION STATUS FOR FEDERAL FISCAL YEAR (FFY) 2024: JULY 1, 2024 - JUNE 30, 2025 The purpose of this memo is to communicate the determination status for the Wisconsin Birth to 3 Program and the determination status for each local Birth to 3 Program for FFY 2024. The Office of Special Education Programs (OSEP) within the U.S. Department of Education requires states to monitor and enforce the Individuals with Disabilities Education Act (IDEA) by issuing local determinations annually per 34 CFR 303.700(a)(2), specific to the performance of each early intervention program. The State of Wisconsin and Walworth County Birth to 3 Program determination statuses for FFY 2024 are listed below. Wisconsin’s overall Determination Status is “Meets Requirements” Walworth County Birth to 3 Program Determination Status is “Meets Requirements.” This communication includes the attached documents and links: 1. The official Determinations Results and Compliance Matrix. (PDF) 2. Determinations Results and Compliance Matrix Instructions (P-02398i-2022) 3. County Birth to 3 Program – Annual Determinations Analysis Summary (2026) 4. County Birth to 3 Program – Improvement Plan (2026) (Optional for programs in Meets Requirements and Needs Assistance for the first year) 5. 2026 Determinations Follow-Up Activities and Technical Assistance Details (PDF) Important: This attached document provides details on required activities to complete. According to the Part C Regulations (34 CFR 303.700(d)), states must monitor each local program and apply enforcement actions for identified determinations. Counties in “Meets Requirements” status must: • Complete the Determinations Analysis Summary (2026) by 8/5/2026. Note: Please refer to the 2026 Determinations Follow-Up Activities and Technical Assistance Details document attached and the “Annual County Birth to 3 Program Determinations: Follow-Up Activities and Technical Assistance (TA) Requirements” (checklist) for more details of the required activities. County programs in all status categories are encouraged to attend the Determinations Analysis Technical Assistance Forums. Page 40 of 46 2 Contact the BCS Technical Assistance Center Inbox dhsbcstac@dhs.wisconsin.gov with any questions and to schedule technical assistance (required). On behalf of the Department of Health Services, thank you for your commitment to the children and families of your community. cc Regena Floyd-Sambou, Children and Family Program Specialist, Determinations TA Lead Page 41 of 46 P-02398B (03/2026) 1 Walworth County’s 2024-25 Determinations Results and Compliance Matrix Table 1 Overall Percentage and Determination 81.94% Meets Requirements Results and Compliance Overall Score Total Determination Points Available County Determination Points Received Score % Results 8 6 75.00% Compliance 9 8 88.89% Total Result and Compliance Score 81.94% Participation in Fiscal Reconciliation Participation Results Fiscal Reconciliation Complete and Timely Participation Total Impact on Determination Status No Change to Determination Status Table 2 Results Component 1&2 – Data Quality & Completeness Calculating useable child outcomes data State Average % County % Walworth County # Determination Points Received Determination Points Available In the Program less Than Six Months 28.31% 26.04% 25 NA NA Unfixable Errors 0.72% 2.08% 2 1 2 Total Usable Child Outcomes 70.97% 71.88% 69 2 2 Totals 100.00% 100.00% 96 3 4 Page 42 of 46 P-02398B (03/2026) 2 Table 3 Results Component 3 – Children’s Performance Outcome Summary Statement State Target County’s 2023-24 Results County’s 2024-25 Results SSP Received SSP Available A. Positive social-emotional skills Summary Statement 1: Of those infants and toddlers who entered early intervention below age expectations in each Outcome, the percent who substantially increased their rate of growth by the time they turned 3 years of age or exited the program. 59.34% 71.88% 71.21% 2 2 Summary Statement 2: The percent of infants and toddlers who were functioning within age expectations in each Outcome by the time they turned 3 years of age or exited the program. 42.30% 28.13% 36.23% 1 2 B. Acquisition and use of knowledge and skills Summary Statement 1: Of those infants and toddlers who entered early intervention below age expectations in each Outcome, the percent who substantially increased their rate of growth by the time they turned 3 years of age or exited the program. 64.57% 76.19% 70.59% 2 2 Summary Statement 2: The percent of infants and toddlers who were functioning within age expectations in each Outcome by the time they turned 3 years of age or exited the program. 31.30% 17.19% 28.99% 1 2 Page 43 of 46 P-02398B (03/2026) 3 Table 3 Results Component 3 – Children’s Performance Outcome Summary Statement State Target County’s 2023-24 Results County’s 2024-25 Results SSP Received SSP Available C. Use of Appropriate Behavior to meet their needs Summary Statement 1: Of those infants and toddlers who entered early intervention below age expectations in each Outcome, the percent who substantially increased their rate of growth by the time they turned 3 years of age or exited the program. 65.29% 65.63% 80.88% 2 2 Summary Statement 2: The percent of infants and toddlers who were functioning within age expectations in each Outcome by the time they turned 3 years of age or exited the program. 45.08% 25.00% 33.33% 1 2 Points Calculated for Results Component 3 - Children’s Performance SSP Received SSP Available Total Amount of SSP 9 12 Total Determination Points 3 4 Table 4 Compliance Component - Monitoring Priorities and Indicators Indicator State Target State Results County Results Points Received 1. Percent of infants and toddlers with individualized family service plans (IFSPs) who receive the early intervention services on their IFSPs in a timely manner. 100.00% 99.91% 100.00% 1 2. Percent of infants and toddlers with IFSPs who primarily receive early intervention services in the home or community-based settings. 99.00% 99.49% 100.00% 1 3. See Table 3 Page 44 of 46 P-02398B (03/2026) 4 Table 4 Compliance Component - Monitoring Priorities and Indicators Indicator State Target State Results County Results Points Received 4. Percent of families participating in Part C who report that early intervention services have helped the family: a. Know their rights b. Effectively communicate their children’s needs c. Help their children develop and learn 81.19% 86.40% 84.06% 81.25% 85.71% 81.11% 57.14% 57.14% 57.14% NA NA NA 5. Percent of infants and toddlers birth to 1 with IFSPs compared to national data 1.09% 1.16% 0.85% NA 6. Percent of infants and toddlers birth to 3 with IFSPs compared to national data 3.04% 3.55% 2.94% NA 7. Percent of eligible infants and toddlers with IFSPs for whom an initial evaluation, initial assessment, and initial IFSP meeting were conducted within Part C’s 45-day timeline 100.00% 99.62% 100.00% 1 8A. Percent of toddlers with disabilities exiting Part C with timely transition planning for whom the lead agency has developed an IFSP with transition steps and services at least 90 days and at the discretion of all parties, not more than nine months, prior to the toddler’s third birthday. 100.00% 99.88% 100.00% 1 8B. Percent of all toddlers with disabilities exiting Part C with timely transition planning for whom the lead agency has notified (consistent with any opt-out policy adopted by the state) the SEA and LEA where the toddler resides at least 90 days prior to the toddler’s third birthday for toddlers potentially eligible for Part B preschool services. 100.00% 98.80% 98.15% 1 Page 45 of 46 P-02398B (03/2026) 5 Table 4 Compliance Component - Monitoring Priorities and Indicators Indicator State Target State Results County Results Points Received 8C. Percent of all toddlers with disabilities exiting Part C with timely transition planning for whom the lead agency has conducted the transition conference held with the approval of the family at least 90 days, and at the discretion of all parties, not more than nine months prior to the toddler’s third birthday for toddlers potentially eligible for Part B preschool services. 100.00% 98.77% 91.30% 0 9. Percent of hearing requests that went to resolution sessions that were resolved through resolution session settlement agreements (applicable if Part B due process procedures are adopted). NA NA NA 1 10. Percent of mediations held that resulted in mediation agreements. 100.00% NA NA 1 Timely correction of a finding of non-compliance (general supervision). 100.00% 100.00% NA 1 Points Received for Compliance Component Total Determination Points Total determination points possible Total determination points received for Walworth County 9 8 Page 46 of 46