Health & Human Services Board - Regular Meeting — Agenda Packet

Chippewa County Health & Human Services Board Regular Meeting September 17, 2026 Chippewa County Courthouse, Room 302 8:00 AM Kari Ives, Chair District 21 Dennis Bachman, Vice-Chair District 5 District 15 Lee Hennick Citizen Rep John Halbleib District 8 James Ericksen Citizen Rep Marcia Kyes District 2 Pam Guthman Citizen Rep, MD Robert Bullwinkel Citizen Rep,MD Sandy Frohling Page 1 of 37 Chippewa County Health & Human Services Board Regular Meeting September 17, 2026 Chippewa County Courthouse, Room 302 8:00 AM 1. Call to Order 2. Roll Call 3. Members of the Public Wishing to Be Heard (Comments will be limited to 5 minutes per speaker.) 4. Consent Agenda (Unless separation of an item is requested, all items will be adopted under one motion.) 1. Approve the Agenda 2. Approve the Minutes - August 20, 2026 3. Schedule Next Meeting Date - October 15, 20206 5. Reports 1. Public Health Policy, Practice, and Program Success — Nutrition Division - Amy Ralph/April Krumenauer 2. Public Health Director’s Program and Financial Report – Sarah McQuillan 3. Chippewa County Community Health Assessment Update - Nikki Hoernke 4. Human Services Director’s Program and Financial Report – Bobbie Jaeger 6. Business Items 7. Agenda Items for Future Consideration 8. Adjourn Chippewa County shall attempt to provide reasonable special accommodations to the public for access to its public meetings, provided reasonable notice of special need is given. If special accommodations for a meeting are desired, contact the County Clerk’s Office at 715-726- 7980. Members of the Chippewa County Board of Supervisors who are not members of this committee are entitled to attend this meeting. It is possible that the attendance of one or more such nonmember Supervisors may create a quorum of some other county board committee, board or commission. Such a quorum is unintended and the nonmember Supervisors are not meeting for the purpose of exercising the responsibility, authority, power, or duties of any other committee, board or commission. Published: September 10, 2026 Page 2 of 37 Chippewa County Health & Human Services Board Regular Meeting August 20, 2026 Chippewa County Courthouse, Room 302 8:00 AM 1. Call to Order The Chair called the meeting to order at 08:00 AM 2. Roll Call Members Present: Kari Ives, James Ericksen, Dennis Bachman, John Halbleib, Marcia Kyes Members Absent: Lee Hennick, Pam Guthman, Sandy Frohling, MD, Robert Bullwinkel, MD Others Present: County Administrator Andy Albarado; Human Services Staff: Bobbie Jaeger, Brandi Engel, Paul Brenner, Kyra Secraw; Public Health Staff: Brittnay Fortuna, Audra Knowlton, Sarah McQuillan 3. Members of the Public Wishing to Be Heard (Comments will be limited to 5 minutes per speaker.) There were no members of the public wishing to be heard. 4. Consent Agenda (Unless separation of an item is requested, all items will be adopted under one motion.) Motion: Approved Result: Passed (5 - 0) Mover: John Halbleib Seconder: James Ericksen Ayes: Kari Ives, James Ericksen, Dennis Bachman, John Halbleib, Marcia Kyes Nayes: None Absent: Lee Hennick, Pam Guthman, Sandy Frohling, MD, Robert Bullwinkel, MD 1. Approve the Agenda 2. Approve the Minutes - July 16, 2026 3. Schedule Next Meeting Date - September 17, 2026 5. Reports 1. Aging and Disability Resource Center Board Minutes - July 9, 2026 Minutes of the July 9, 2026, Aging & Disability Resource Center Board meeting were attached for informational purposes. 2. Human Services Policy, Practice, and Program Success - Kyra Secraw Kyra Secraw is the manager for the Children, Youth & Families Division, Youth Justice, and Children with Differing Abilities. The Children’s Long-Term Support (CLTS) and Children’s Comprehensive Community Services (CCS) are voluntary programs. She discussed the eligibility of the programs and their services. The Page 3 of 37 CLTS Dashboard shows the wait time until enrollment and the total enrollments since January 2025. They contract with Public Health to provide a single point of entry to conduct functional screens. CCS staff may have clients who are also receiving CLTS services. 3. Human Services Director's Program and Financial Report - Bobbie Jaeger Human Services Director Bobbie Jaeger presented the Human Services Program and Financial Report. She included the WCHSA PAC committee recommendations in her report. One priority is to focus on support for increased funding for crisis and adult protective services. She highlighted information on income maintenance and BadgerCare Plus work requirement data. Congratulations to staff celebrating work anniversaries, especially Kelly Zimmerman, Michelle Phelps, and Trish Houle, celebrating 20 years. ADRC hired a site aide; Birth to Three received a score of 100 percent on their state annual determination; and Adult Protective Services received 18 referrals in 10 days. This data will be included in the dashboard. Jaeger encouraged members to review the Federal Medicaid Work Requirement flyer included in the agenda packet. The department is working on reducing projected budget overages for out-of-home placements. 4. Public Health Director’s Program and Financial Report - Brittnay Fortuna Public Health Director Brittnay Fortuna presented the Public Health Program and Financial Report. Administration is working on overdue Food, Safety, and Recreational Licensing renewals. Business owners who have not paid for their renewal will now be receiving cease-and-desist letters. Their businesses will close, and they will be required to pay a pre-inspection fee and permit fee to reopen. She highlighted from her report: April is the Breastfeeding Peer Counselor and is assigned to 93 families; BadgerCare Plus has extended their postpartum coverage to 12 months; air-quality preparedness update; communicable disease data; measles update; increased cases of hand foot and mouth; environmental health division updates; August in National Breastfeeding Month; Chippewa County has a higher rate of breastfeeding mothers than the state rate; Fun at the Farmers Market classes have ended; issued more than 90 percent of the Farmers Market program and 350 sets of Farm Fresh Produce vouchers; Mind of Matter program will begin in August; community outreach at back-to-school events; and Children’s Resource Center (CRC)- West provided a hospital bag and gas card for a family. Congratulations to the staff celebrating work anniversaries, especially Jenny Lenbom, celebrating 20 years. Fortuna reviewed the dashboard for the CRC and the Accreditation dashboard status. The department has an accepted offer for the RN vacancy. Discussion was held on immunizations, including measles vaccinations. 6. Business Items 1. Resolution Supporting Increased and Sustainable State Funding for Local Public Health Departments Public Health Director Brittnay Fortuna noted that county health departments are asking their boards to support more public health funding from the state. The Wisconsin Counties Association will advocate to reduce reliance on local tax levy to fund foundational public health services. The Board approved forwarding the resolution supporting increased and sustainable state funding for local public health departments to the County Board. Motion: Forwarded to the County Board Result: Passed (7 - 0) Mover: Marcia Kyes Seconder: Sandy Frohling, MD Ayes: Kari Ives, James Ericksen, Dennis Bachman, John Halbleib, Sandy Frohling, MD, Robert Bullwinkel, MD, Marcia Kyes Nayes: None Page 4 of 37 Absent: Lee Hennick, Pam Guthman 7. Agenda Items for Future Consideration 8. Adjourn The meeting adjourned at 8:34 AM. Motion: Approved Result: Passed (7 - 0) Mover: James Ericksen Seconder: Marcia Kyes Ayes: Kari Ives, James Ericksen, Dennis Bachman, John Halbleib, Sandy Frohling, MD, Robert Bullwinkel, MD, Marcia Kyes Nayes: None Absent: Lee Hennick, Pam Guthman Page 5 of 37 Statement of Explanation Public Health Policy, Practice, and Program Success — Nutrition Division - Amy Ralph/April Krumenauer 1 Nutritionist Amy Ralph and Breastfeeding Peer Counselor April Krumenauer provide 2 education on the WIC Breastfeeding Peer Counseling program and share a success story. Page 6 of 37 9/2/2026 1 Breastfeeding Peer Counselor Program Presenters: Amy Ralph, MS, RD, CD, CLC & April Krumenauer, BFPC WIC Breastfeeding Peer Counseling (BFPC) Core Program Components • Evidence-based model: Launched in 2004 using the USDA WIC breastfeeding model to increase breastfeeding initiation and duration. • Peer-to-Peer Support: Connects pregnant and postpartum WIC participants with trained peer counselors-mothers from the same community-who provide guidance and support to help them achieve their breastfeeding goals. • Personalized Guidance: Counselors offer personalized encouragement, tips for maintaining milk supply when returning to work/school, and basic support, helping to increase breastfeeding duration and success for WIC families. 1 2 Page 7 of 37 9/2/2026 2 BPFC Services Offered • Advanced Referrals: Peer Counselors provide basic information and refer complex cases to WIC Designated Breastfeeding Experts (DBEs) or International Board Certified Lactation Consultants (IBCLCs). • Ongoing Contact: Counselors contact moms during pregnancy, in the early days postpartum, and throughout the breastfeeding journey. • Diverse Communication: Support is available via phone, text, email, or in-clinic visits. • Education: BFPC share educational materials, information for classes and support groups, phone number for questions, and peer and professional lactation support staff. WIC BFPC Program • Availability: Counselors are often available outside standard WIC clinic hours to provide timely support. • Goal: The program aims to increase breastfeeding initiation, and duration rates amount WIC participants, who are often from underserved or minority communities. 3 4 Page 8 of 37 9/2/2026 3 Benefits of BFPC • Percentage of WIC moms who have initiated breastfeeding has increased dramatically – from 42% in 1998 to 83% in 2025 for Chippewa County (Mom on WIC prenatally), and 77.7% statewide. • Breastfeeding duration has improved in WIC at 6 mo. postpartum – from 41.9% of Chippewa County WIC moms (30.7% statewide) still breastfeeding in 2025, compared to 12% of WIC moms in 1997. • Peer counselors understand the difficulties and provide realistic and practical guidance because of shared personal backgrounds and experience in ways that most health professionals cannot. • Peer counselors are more cost-effective than professional lactation staff. WIC BFPC • Provides basic breastfeeding information and support • Tips for how to breastfeed comfortably, even in public. • Ways you can stay close to your baby through breastfeeding after you return to work or school. • Ideas for getting support from your family and friends. • Ways to get a good start with breastfeeding. • Tips for making plenty of breast milk for your baby. • Help with breastfeeding concerns. • Listen to you, encourage you, and respect your wishes to help meet your breastfeeding goals. • Guidance on how to understand baby’s sleep, cues, crying. 5 6 Page 9 of 37 9/2/2026 4 Chippewa County BFPC: April Krumenauer • Has been Chippewa County’s BFPC for 12 years. • Breastfed her 3 children. • When there are breastfeeding questions and issues outside of her scope of practice, refers to DBE (Amy). • 391 total successful contacts in 2025 with 185 unduplicated women who’ve had a successful contact with April. • Current Caseload: 93 families, 52 pregnant participants and 40 BF participants. • Caseload has been continuing to increase and BFPC program is well received by our WIC participants. • At 6 months postpartum a survey is sent out about the BFPC program. Survey Responses • She helped me know what was coming from fussiness, to how much she'll start to eat/feed. • She always knew where my baby was at developmentally and offered great advice and guidance. • She helped me achieve my dream of exclusive breast feeding and provided outstanding encouragement. • Having a supportive person in my corner when I felt I was failing. I truly think my breastfeeding journey would've ended without this program from WIC. I could message her about any question I had. She'd give me valuable feedback, tips, and motivation to keep up the wonderful job! • I can ask a lot of questions even if they were kind of stupid, but I'm very thankful. • I was given information that was needed that I didn't even think about. 7 8 Page 10 of 37 9/2/2026 5 Success Story-Makala • Example of text message to April from Makala • Hi, I'm doing well. First day of work was okay. I pumped in my car on my lunch break the first day then training got pushed back until tomorrow. My manager did talk to management at Walmart and there is a room I can use in the back to pump she just wasn't sure exactly where it was, so tomorrow I am going to figure out exactly where that room is located. Lennon is tolerating and drinking half breastmilk and half nutramigen formula :) and I have been able to have a stock of fresh breastmilk in the freezer so I am a lot less stressed out about being able to continue pumping and feeding her my breastmilk with a little bit of a supplement of formula instead of all formula and I still have her nurse and drink full bottles of breastmilk as well Makala’s milk supply 9 10 Page 11 of 37 9/2/2026 6 Lennon QUESTIONS? 11 12 Page 12 of 37 Statement of Explanation Public Health Director’s Program and Financial Report – Sarah McQuillan 1 In Public Health Director Brittnay Herrick's absence, Public Health Fiscal Manager Sarah 2 McQuillan will provide the department's program and financial report for review and 3 discussion. Page 13 of 37 1 September 17, 2026 Health & Human Services Board Brittnay Herrick’s Director’s Report Administration Division In August, Nikki, Audra, April, and representatives from Chippewa County Healthy Communities attended the National Night Out event at the Northern Wisconsin State Fairgrounds. They provided educational outreach to children and parents on a variety of Public Health services and programs, including WIC, car seat safety, water testing, the medical equipment loan program, and harm reduction. The Administrative Team continues to play a key role in the daily operations of our department. We provide support by scheduling appointments, responding to car seat safety inquiries, lending wheelchairs, completing month-end reporting, and billing. Our team also serves as a reliable resource for general Public Health questions, helping connect community members with the information and services they need. Community Health Division Think Outside the Stigma Campaign: Promoting Recovery, Hope, and Community Chippewa County continues to expand efforts to reduce stigma related to substance use disorder, promote harm reduction, and increase awareness of recovery resources. In recognition of International Overdose Awareness Day on August 31, three new “Think Outside the Stigma” billboards were added throughout the county. The new billboards are located at: • Hwy 29/Hwy 40 in Elk Mound • Hwy 53/Hwy 40 in Bloomer • Hwy 27 in Cornell Page 14 of 37 2 December 18, 2025 These join the two original campaign locations at Hwy 27 in Cadott and Hwy 53/County Hwy OO in Lake Hallie, expanding the campaign’s reach to communities across Chippewa County. The “Think Outside the Stigma” campaign builds on the 2025 “Harm Reduction Saves Lives, Stigma Doesn’t” campaign and was developed through collaboration between the Chippewa County Department of Public Health, Overdose Fatality Review Team, Recovery Court, community partners, and individuals with lived experience. A unique aspect of this campaign is that the billboard artwork was created by a participant in the Chippewa County Recovery Court program. The design reflects the artist’s lived experience with stigma, substance use disorder, mental health challenges, and recovery. Through Recovery Court and involvement with the Chippewa County Harm Reduction Workgroup, the artist has had opportunities to share their experience, contribute to community efforts, and use their creativity to promote hope and recovery. The campaign emphasizes that recovery is possible and that individuals should not be defined by their past experiences or substance use. Reducing stigma can help create an environment where people feel more comfortable seeking treatment, accessing harm reduction resources, and connecting with support. This work also demonstrates the value of incorporating lived experience into public health efforts. Bringing together individuals with lived experience, Public Health, Recovery Court, the Overdose Fatality Review Team, and other community partners helps ensure that messaging and strategies reflect the experiences and needs of the people most directly affected. The billboard expansion also provides an opportunity to transition the campaign into Recovery Month activities in September, continuing to highlight recovery, connection, and community support. Community members can contribute by learning about substance use disorder, carrying naloxone, connecting others to resources, and approaching individuals and families affected by substance use with compassion rather than judgment. The “Think Outside the Stigma” campaign is one component of Chippewa County’s broader efforts to prevent overdose, reduce stigma, expand harm reduction, and strengthen pathways to treatment and recovery. It also demonstrates how collaboration and lived experience can inform meaningful, community-centered public health messaging. Page 15 of 37 3 December 18, 2025 Measles Update Wisconsin continues to respond to an ongoing measles outbreak, with cases primarily concentrated in southwest Wisconsin. As of September 1, 2026, the Wisconsin Department of Health Services (DHS) reported 102 confirmed and six probable outbreak-associated cases and 110 total measles cases statewide in 2026. Measles virus was also detected in wastewater samples collected in Grant County, providing an additional tool for monitoring community transmission. Chippewa County Department of Public Health continues to monitor the situation closely and remains prepared to respond to any potential cases or exposures in our community. Staff are reviewing current measles response plans, maintaining awareness of testing and reporting requirements, and monitoring guidance and updates from DHS. Maintaining high measles, mumps, and rubella (MMR) vaccination coverage remains one of the most effective ways to prevent the spread of measles and protect individuals who cannot be vaccinated. As children and families return to school and regular activities, CCDPH will continue to share accurate information with community partners and encourage residents to review their vaccination status. The department will also continue coordinating with healthcare and public health partners as needed to support early identification, testing, reporting, and response to any suspected measles cases. For more information, visit the Measles Data Dashboard. Foodborne Illness and Enteric Disease Update Foodborne illness has received increased national attention this summer, with several multistate outbreaks involving Cyclospora, Salmonella, and E. coli. While increases in reported illness can reflect several factors, including increased disease activity and improved testing and disease detection, recent activity highlights the continued importance of foodborne illness surveillance and outbreak response. Chippewa County is also seeing an increase in reported enteric diseases. Enteric diseases are infections that affect the gastrointestinal system and can spread through contaminated food or water, person-to-person contact, or contact with infected animals. Common enteric illnesses include Salmonella, Campylobacter, cryptosporidiosis, and certain types of E. coli. Page 16 of 37 4 December 18, 2025 In July 2026, the County received an increased number of reports of several enteric illnesses, including E. coli, cryptosporidiosis, and salmonellosis. Activity remained elevated in August, including reports of Shiga toxin-producing E. coli (STEC). STEC is of particular public health concern because some infections can cause severe gastrointestinal illness and, in rare cases, lead to serious complications, including kidney failure. Because STEC can be associated with foodborne outbreaks and person-to- person transmission, these reports require close follow-up to identify potential sources of exposure, determine whether illnesses may be connected, and prevent further spread. While the increase in reports does not necessarily indicate a local outbreak or common source, it reinforces the importance of continued surveillance and timely investigation. CCDPH works with healthcare providers, laboratories, and state partners to investigate reported illnesses, identify potential connections, and provide guidance to prevent additional cases. The department will continue to monitor local enteric disease trends and respond to suspected cases and outbreaks as needed. Communicable Disease The Health Officer is required by Wisconsin State Statute 252.05 to report information on current communicable disease reporting and follow-up to the Health and Human Services Board. In August, we received 130 new reports: 26 confirmed (5 Chlamydia, 5 Lyme Disease-Erythema Migrans (EM) Rash, and 2 Pertussis); 16 probable cases (12 Lyme Laboratory Reports and 1 Cryptosporidiosis, 1 Carbon Monoxide Poisoning); and 67 that did not meet the definition of a case (23 Lyme Laboratory Reports, 8 Hepatitis A, and 7 Hepatitis C). See the attached report for further breakdown by disease type. Environmental Health Division (EH) Our environmental health team is wrapping up the summer with routine inspections and water sampling. As the seasonal facilities come to their end of operation for the year, the team has been prioritizing those inspections. Many businesses are still looking to get started and the team completed 12 pre-inspections for the licensing program. The team completed 38 routine inspections but discovered and wrote 55 violations in total in the month of August! Top violations were: 1. Cold holding issues: Facilities were improperly cold holding food, and food was discovered to be between the temperature range of 44-52 degrees Fahrenheit. Food must be cold held at 41 degrees or below! 2. Unable to access hand-wash sinks: Multiple times, inspectors found hand-wash sinks being inoperable or used for other purposes rather than handwashing! 3. Date Marking: When a product is open or cooked, the potentially hazardous food has seven days to be used up when being cold held! This helps prevent selling spoiled or hazardous food. Page 17 of 37 5 December 18, 2025 Four facilities did not renew or pay for their invoices to renew their 2026-2027 license, so the department had to issue cease-and-desist orders to these individuals. Letters were typed and sent to each individual explaining they must stop business immediately and reapply for a license. Not only were our inspectors busy, but the water lab was busy as well! • 40 TN bacteria samples were collected and processed in-house • 16 TN nitrate samples were collected and processed in August. • With beach season ending as well, the team completed and assessed 44 beach water samples and tested for E. coli levels. Blue-green algae was also observed a couple of times across the county. • Private homeowners brought in 19 bacteria samples to be tested for coliform and E. coli. • Our water lab processed 20 nitrate samples for our community. • In total, the water lab processed approximately 2.75 gallons of water this month! We’re super proud of our environmental health team for pushing through the high temperatures this month and being in the field daily to get their seasonal inspections completed! Lots of behind-the-scenes work was completed by the team in preparation for our annual DATCP and DSPS agent review for the last licensing year. Policies and procedures were reviewed and edited, new processes were developed, and more quality improvement projects were being completed. Nutrition Division Women, Infants and Children (WIC) Program On September 1, the U.S. House passed a continuing resolution (CR) extending government funding through December 11, 2026. The measure passed with broad bipartisan support in both the House and Senate and is expected to be signed by the President, avoiding another government shutdown when the current fiscal year ends later this month. The CR includes spending flexibility for WIC to ensure that every eligible family seeking services can continue to participate. However, Congress must still pass a full-year FY27 agriculture appropriations bill to give providers and families long-term certainty. The measure also fails to grant permanent authority for WIC’s flexible service delivery. In the meantime, USDA has indicated that it will allow virtual services to continue. Breastfeeding data WIC Breastfeeding Data Local Agency Dashboards New breastfeeding data was recently released. While breastfeeding rates decreased overall nationally, Wisconsin WIC and Chippewa County WIC data have improved with more infants receiving breastmilk than last year. This improvement reflects the education and support provided not only by the WIC Program, but also by our hospitals, clinics, employers, and communities to encourage and support breastfeeding families, which is essential in helping families meet their goals. Page 18 of 37 6 December 18, 2025 Farmers Market updates As of August 24, 100 percent of our Farmers Market Nutrition Program (FMNP) checks have been issued. This is the first time we’ve had 100 percent issuance. We have also distributed 407 sets of WIC Farm Fresh Produce Program vouchers and have almost 100 additional sets that we can distribute throughout September and October to assure access to fresh locally grown produce for all WIC families. Marshfield/Security Health Plan Food Insecurity Grant We are encouraging farmers, gardeners, and growers in Chippewa County to share extra produce with others in our community by donating any surplus fruits and vegetables to a local food pantry. All pantries that we talked to earlier this summer were willing to accept donations during regular operating hours or by calling ahead to arrange a convenient drop-off time. Please visit the Chippewa County Food Resource Page to find local food pantries hours and other food resources: Access to Healthy Food | Chippewa County Healthy Communities. Partners are encouraged to share our Facebook post in their communities to spread the word: Facebook WIC Breastfeeding Data Local Agency Dashboard for FY24 Agency % infants fully breastfed % infants partially breastfed % infants receiving any breastmilk % infants fully formula fed Chippewa County WIC 30.64% 10.4% 41.04% 58.96% All Wisconsin WIC Agencies 18.2% 16.67% 34.87% 65.13% All US WIC State Agencies 16.02% 26.38% 42.4% 57.6% WIC Breastfeeding Data Local Agency Dashboard for FY25 Agency % infants fully breastfed % infants partially breastfed % infants receiving any breastmilk % infants fully formula fed Chippewa County WIC 35.26% (↑) 11.58% (↑) 46.84% (↑) 53.16% (↓) All Wisconsin WIC Agencies 19.3% (↑) 18.13% (↑) 37.43% (↑) 62.57% (↓) All US WIC State Agencies 14.15% (↓) 11.32% (↓) 25.47% (↓) 74.53% (↑) Page 19 of 37 7 December 18, 2025 Planning and Strategy PHAB Reaccreditation Update Great news! We have officially completed writing 100% of our documentation for PHAB reaccreditation. This involved compiling nearly 100 pieces of evidence that highlight the department’s impressive work over the last five years. Next steps in the reaccreditation process include: 1. Pre–Site Visit Review: A PHAB Accreditation Specialist will review our submitted documentation for completeness, followed by a peer review team will assess it against the PHAB 2022 Standards & Measures. 2. Clarification Window (45 Days): If reviewers identify any gaps or areas needing clarification, PHAB will issue a Pre–Site Visit Review Report. We will then have 45 days to upload additional information or revise narratives. 3. Virtual Site Visit: Once documentation is approved, PHAB will conduct a virtual site visit (1–2 days) to speak with leadership, staff, and community partners (as needed) to verify the evidence submitted. 4. Site Visit Report: PHAB’s review team will prepare a report summarizing our performance across all measures and outlining strengths and opportunities for improvement. 5. Final Accreditation Decision: The PHAB Accreditation Committee will review the Site Visit Report and issue one of three decisions: o Continued accreditation (5-year cycle continues) o Accreditation Committee Action Requirements (ACAR) with up to one year to address specific gaps o Not accredited 2026 Community Health Assessment Survey The 2026 Community Health Assessment Survey is now underway across the Chippewa Valley. The survey was developed jointly by the Chippewa County Department of Public Health, Dunn County Health Department, and Eau Claire City-County Health Department, in partnership with Aspirus Health, Chippewa Valley Health Cooperative, Mayo Clinic Health System, Rogers Behavioral Health, and United Way of the Greater Chippewa Valley. It represents the data-collection phase of the tri- county Community Health Assessment process, gathering input directly from residents and workers on the health priorities and concerns that matter most to their communities. The survey is open now and will run through October 2026. It's available both online and in paper form, and has been translated into English, Hmong, and Spanish to reach as broad an audience as possible. Residents can complete it online at https://qrco.de/cha2026e. Paper copies are also available through the health department. Looking ahead, community conversations will be held across all three counties this fall to share survey results and discuss the factors contributing to community health. In spring 2027, each county will release its own Community Health Assessment report based on this input, which will in turn guide the Page 20 of 37 8 December 18, 2025 development of new Community Health Improvement Plans, setting priorities for local public health work. Years of Service CONGRATULATIONS to the following staff for their hard work and dedication to providing excellent customer service to the citizens of Chippewa County.  Audra Knowlton, Administrative Assistant – 26 years  April Krumenauer, Administrative Assistant – 13 years  Kyle Ziegler, Environmental Health Specialist – 6 years  Amy Ralph, Nutritionist – 5 years  Mary Rudd, Nutrition Program Assistant LTE – 5 years  JoAnna Bernklau, Planning and Promotion Specialist – 3 years  Reggie Eggen, Environmental Health Specialist LTE – 1 year Page 21 of 37 9 Page 22 of 37 Disease Confirmed Probable Suspect Not A Case Total LYME LABORATORY REPORT 0 12 2 23 37 HEPATITIS A 0 0 0 8 8 HEPATITIS B, CHRONIC 0 0 1 6 7 HEPATITIS C, CHRONIC 0 0 0 7 7 CHLAMYDIA TRACHOMATIS INFECTION 5 0 0 0 5 CRYPTOSPORIDIOSIS 3 1 1 0 5 E-COLI, ENTEROPATHOGENIC (EPEC) 1 0 3 1 5 LYME DISEASE, ERYTHEMA MIGRANS (EM) RASH 5 0 0 0 5 PERTUSSIS (WHOOPING COUGH) 2 0 0 3 5 HAEMOPHILUS INFLUENZAE, INVASIVE DISEASE 0 0 0 4 4 LEAD-BLOOD LEVELS - ADULT 0 0 0 4 4 TUBERCULOSIS, LTBI - LABORATORY RESULTS ONLY 0 0 4 0 4 ANAPLASMOSIS, A. phagocytophilum 0 1 1 1 3 BABESIOSIS 1 0 2 0 3 E-COLI, SHIGA TOXIN- PRODUCING (STEC) 2 0 1 0 3 STREPTOCOCCAL DISEASE, INVASIVE, GROUP A 0 0 3 0 3 CAMPYLOBACTERIOSIS 2 0 0 0 2 CARBAPENEMASE PRODUCING ORGANISM (CPO) 0 0 0 2 2 Jurisdiction: Chippewa County County Board of Health Report Wisconsin Department of Health Services Division of Public Health PHAVR - WEDSS Received Date: 8/1/2026 to 8/31/2026 Executed: 9/3/2026 10:46:15 AM Page 1 of 2 Page 23 of 37 Disease Confirmed Probable Suspect Not A Case Total CARBON MONOXIDE POISONING 0 1 1 0 2 MYCOBACTERIAL DISEASE (NON- TUBERCULOUS) 2 0 0 0 2 SYPHILIS REACTOR 0 0 0 2 2 VARICELLA (CHICKENPOX) 0 0 0 2 2 ASBESTOSIS 0 0 1 0 1 BORDETELLA HOLMESII 0 0 0 1 1 CORONAVIRUS, NOVEL 2019 (COVID-19) 1 0 0 0 1 GIARDIASIS 1 0 0 0 1 GONORRHEA 1 0 0 0 1 MEASLES (RUBEOLA) 0 0 0 1 1 METHICILLIN- or OXICILLIN RESISTANT S. AUREUS (MRSA/ORSA) 0 0 0 1 1 PARAPERTUSSIS 0 0 0 1 1 POLIOMYELITIS 0 0 1 0 1 SYPHILIS, EARLY NON- PRIMARY, NON- SECONDARY 0 1 0 0 1 Total 26 16 21 67 130 Default Filters: 'State' EQUAL TO 'WI' Executed: 9/3/2026 10:46:15 AM Page 2 of 2 Page 24 of 37 Public Health Financial Results August 2026 Revenue Expense Fund Description Budget Actual % Collected Budget Actual % Spent 54100 Community Health (554,657.00)$ (529,891.21)$ 95.5% 554,657.00$ 331,036.51$ 59.7% 54121 Nurse Family Partnership (134,610.00) (105,158.13) 78.1% 134,610.00 97,281.12 72.3% 54122 Beach Water Testing - (2,095.12) #DIV/0! - 9,686.49 #DIV/0! 54123 Farmers Market (1,397.00) (295.28) 21.1% 1,397.00 1,347.26 96.4% 54124 CRC West Peer Support - (8,563.64) #DIV/0! - 15,238.52 #DIV/0! 54125 Prenatal Care Coordination (26,697.00) (14,652.84) 54.9% 26,697.00 22,033.72 82.5% 54126 FP Dual Protection - (3,145.16) #DIV/0! - 3,503.97 #DIV/0! 54128 Public Health Preparedness (35,386.00) (21,086.92) 59.6% 35,386.00 36,322.19 102.6% 54129 TN Program (56,267.00) (33,623.62) 59.8% 56,267.00 23,977.68 42.6% 54130 CHIP Coalition (4,000.00) - 0.0% 4,000.00 119.05 3.0% 54131 Mind Over Matter - - #DIV/0! - 1,526.61 #DIV/0! 54132 Drug Free Community Grant (136,461.00) (66,685.79) 48.9% 136,461.00 75,888.76 55.6% 54133 Iron Will Endowment Fund (1,881.00) (2,593.02) 137.9% 1,881.00 997.43 53.0% 54134 Schaus MD Health Care Endowmen - (544.00) #DIV/0! - 200.00 #DIV/0! 54136 Aspirus Farm Fresh - (6,500.00) #DIV/0! - 215.00 #DIV/0! 54138 Planning & Strategy (368,628.00) (332,361.32) 90.2% 368,628.00 252,894.68 68.6% 54140 WIC (431,791.00) (285,716.25) 66.2% 431,791.00 280,077.67 64.9% 54142 Maternal & Child Health Program (27,759.00) (19,061.24) 68.7% 27,759.00 21,847.04 78.7% 54144 Wisconsin Wins (5,353.00) (1,217.80) 22.7% 5,353.00 3,173.31 59.3% 54149 SAP Services Block Grant (20,319.00) (1,810.34) 8.9% 20,319.00 1,810.34 8.9% 54150 Prevention (9,239.00) (5,308.92) 57.5% 9,239.00 6,649.36 72.0% 54151 Equipment Loan Closet (2,916.00) (634.16) 21.7% 2,916.00 2,447.10 83.9% 54152 Childrens Resource Center (218,267.00) (115,680.60) 53.0% 218,267.00 142,357.50 65.2% 54153 WIC Endowment - (2,559.42) #DIV/0! - - #DIV/0! 54154 Title X Reproductive Health (11,174.00) (17,127.80) 153.3% 11,174.00 20,094.34 179.8% 54156 FIT WIC (47,797.00) (9,828.68) 20.6% 47,797.00 10,061.58 21.1% 54157 Reproductive Health (51,751.00) (27,033.35) 52.2% 51,751.00 27,577.89 53.3% 54158 WIC BF Peer Counseling (24,274.00) (16,119.80) 66.4% 24,274.00 21,865.96 90.1% 54159 Men's Mental Hlth - MC - (10,079.28) #DIV/0! - 4,575.27 #DIV/0! 54161 Health Clinics (48,398.00) (4,861.32) 10.0% 48,398.00 8,229.02 17.0% 54163 Overdose Fatality Review (42,656.00) (15,375.24) 36.0% 42,656.00 28,640.11 67.1% 54165 GYT - Get Yourself Tested (2,129.00) (1,155.52) 54.3% 2,129.00 1,510.78 71.0% 54166 Water Lab (9,138.00) (11,855.00) 9,138.00 23,411.83 256.2% 54167 NW Coalition (18,211.00) (919.92) 18,211.00 15,680.98 86.1% 54168 Farm Fresh Program - (8,824.98) - 510.00 #DIV/0! 54169 PH Vending Machine - (1,000.00) - 949.95 #DIV/0! 54170 Food Insecurity - Marshfield C - (10,539.28) - 14,824.22 #DIV/0! 54171 Food Safety Recreation License (400,594.00) (408,255.88) 400,594.00 261,625.55 65.3% 54172 Infant Immunization Grant (17,056.00) (8,126.24) 47.6% 17,056.00 10,893.15 63.9% 54173 Opioid Abatement (2,348.00) (1,784.64) 2,348.00 8,346.64 355.5% 54174 Forward Health Outreach (32,823.00) (15,096.12) 46.0% 32,823.00 26,572.88 81.0% 54176 Environmental Health (77,139.00) (75,485.55) 97.9% 77,139.00 12,462.32 16.2% 54178 Public Health Infrastructure (106,350.00) (23,306.52) 106,350.00 27,871.97 26.2% 54180 DHS Agreement (166,179.00) (69,107.14) 41.6% 166,179.00 85,862.25 51.7% 54182 Environmental Tracking (10,684.00) (259.72) 10,684.00 259.72 2.4% 54184 Childhood Lead Poisoning Prev. (9,697.00) (1,576.72) 16.3% 9,697.00 1,729.02 17.8% 54186 Charity Outreach Program (250.00) - 0.0% 250.00 152.95 61.2% 54190 Public Health Donation Expendi (1,000.00) (625.00) 62.5% 1,000.00 - 0.0% 3,115,276.00$ 2,297,528.48$ 73.8% 3,115,276.00$ 1,989,586.23$ 63.9% Page 25 of 37 Public Health Revenue vs Expenses Variance Year-to-Date through August 2026 - 500,000 1,000,000 1,500,000 2,000,000 2,500,000 3,000,000 3,500,000 4,000,000 2022 Acutals 2023 Acutals 2024 Actuals 2025 Actuals 2026 YTD Actuals Total Revenues for All Years Taxes Intergov Grants & Aids Licenses & Permits Fines & Forfeitures Public Charges for Services Intergov Charges for Services Misc Revenues Other Financing Sources 0 500,000 1,000,000 1,500,000 2,000,000 2,500,000 3,000,000 3,500,000 4,000,000 2022 Acutals 2023 Acutals 2024 Actuals 2025 Actuals 2026 YTD Actuals Total Expenses for All Years Transfer To Other Funds Capital Outlay Refunds/Restitutions Debt Service Fixed Charges Supplies & Expense Contractual Services Personal Services Page 26 of 37 Statement of Explanation Chippewa County Community Health Assessment Update - Nikki Hoernke 1 Since 1993, Wisconsin State Statutes have required communities throughout Wisconsin 2 to develop and implement local health plans to address health conditions affecting their residents. 3 This process has been referred to as the "Community Health Improvement Process," named 4 partly due to the resulting health status changes in a community and the people who live there. 5 6 Local health departments are required by Wis. Stat. ch. 251.05 to: 7 8 1. Regularly and systematically collect, assemble, analyze, and make available information on 9 the health of the community, including statistics on health status, community health needs, and 10 epidemiological and other studies of health problems. 11 2. Develop public health policies and procedures for the community. 12 3. Involve key policymakers and the general public in determining and developing a 13 community health improvement plan that includes actions to implement the services and 14 functions specified under Wis Stat. § 250. 15 4. Submit data, as requested, to the local public health data system established by the 16 department. 17 18 Nikki Hoernke, Planning and Strategy Division Manager, will provide a background on 19 community health assessments and the local process a Chippewa Valley regional team is using to 20 complete the most recent iteration of the Chippewa County CHA. 21 22 Additional requirements in community health assessments and planning are found in Wis. 23 Admin. Code ch. DHS 140.04. 24 25 Page 27 of 37 CALL TO ACTION COMMUNITY HEALTH ASSESSMENT LOCAL PROCESS A community health assessment (CHA), also known as a community health needs assessment (CHNA), refers to an assessment that identifies key health needs and issues through systematic, comprehensive data collection and analysis. When conducting local health evaluations, organizations must gather information from various sectors of the community, summarize the input received, and describe the community resources that may be available to help address the health needs identified. WHAT IS A CHA? Ask residents to complete the CHA survey. More input helps us understand local health needs and experiences. SHARE THE SURVEY State statute requires health departments to complete a CHA every 5 years, and as part of their tax-exempt status, non-profit hospitals are required to conduct a CHNA every 3 years. The Chippewa Valley region conducts a CHA/CHNA every three years collaboratively with health departments, local hospitals, and community organizations to optimize the coordination and use of resources while reducing duplicative efforts. Connect with local organizations, civic groups, and businesses, and encourage them to share the survey within their networks to boost participation. COLLABORATE Familiarize yourself with the CHA findings so you can help support evidence- based strategies that address community health needs. STAY INFORMED Page 28 of 37 Statement of Explanation Human Services Director’s Program and Financial Report – Bobbie Jaeger 1 Human Services Director, Bobbie Jaeger, and Senior Fiscal Manager, Paul Brenner, 2 provide a department program and financial report for review and discussion. Page 29 of 37 Human Services Director’s Report Board Meeting Date: September 17, 2026 1 WCHSA Updates Division of Children and Families (DCF) and CYF PAC • Evelyn Coker resigned as the director of the Bureau of Youth Services in the Division of Safety and Permanence. Shannon Braden will be serving as the interim director. • Jed Pertl stepped down as the Secretary of the Department of Children and Families effective September 4 th. Nadya Perez-Reyes will be the new acting secretary. • Wisconsin’s Child and Family Services Review (CFSR) kicks off on October 8th. Wisconsin has chosen to conduct a state-led review. Division of Health Services (DHS) • The U.S. House of Representatives passed a Senate-amended continuing resolution (H.R. 6500) on September 1, 2026, extending federal funding through December 11, 2026. • DHS has an online survey for anyone interested in submitting ideas for how the state should allocate opioid settlement funds. The survey is available through September 30 th. WI DHS SFY 2028 Opioid Settlement Public Input Survey • DHS is sending a one-time letter to BadgerCare Plus members who will be impacted by the federal Medicaid work requirement that goes into effect in 2027. These letters were sent between August 7th and September 1st. • 988 Day was September 8th. This is a day of action to spread awareness of the 988 Suicide and Crisis Lifeline. Behavioral Health PAC • At this time, the PAC believes that Counties are the only eligible applicants for crisis hostels. Crisis hostels are short-term (23 hours or less), voluntary, community-based programs with 15 beds or less that de-escalate mental health crisis and prevent the need for inpatient hospitalization. • PAC is providing input on diagnoses to be included in the ICD-10 list for medically frail exemptions of the Medicaid work requirement. • Winnebago Mental Health Institute rate increase of 10% from existing rates October 1, 2026, through September 30, 2027. This is the fourth year in a row with a 10% increase to rates. • PAC is beginning discussions on the Comprehensive Community Services (CCS) rates which have been unchanged since 2014. Page 30 of 37 2 Child Welfare PAC • The University of Wisconsin is conducting a research study on Initial Assessment decision making and screening. Findings of the study are expected in Spring ’27. Income Maintenance PAC • PAC is addressing significant delays in processing system access requests. These delays hinder onboarding and cohort training enrollment for new Economic Support staff. They are also working to improve security forms and manuals to improve the system access process. • On August 25 th Wisconsin lawmakers voted to audit the state’s FoodShare program. Wisconsin Legislative Audit Bureau will conduct the review which will be the first comprehensive evaluation since 2012. The audit will evaluate eligibility policies and practices (accuracy), review program cost and trends, and track participation in Foodshare Employment and Training program (FSET) Long Term Care PAC • Adult Protective Services intake and screening process is being created at the state level with a goal of creating uniformity across the counties. • Working to create a Medicaid presumptive eligibility policy for those waiting on a disability determination. • Preparing a proposal for Children’s Community Options Program (CCOP) funding to sunset CLTS maintenance of effort and distribute remaining funds based on county census data. Financial PAC • Working on a mentorship program for new financial managers • Identifying top reasons for Medicaid payment denials: Duplicate claims, charged over allowable rate, and client lapse in coverage. Department and Division Updates Department Updates Work Anniversary CONGRATS and THANKS to the following staff for their service and dedication: Patty Lemay, CYF – 32 Years Renee Berthiaume, MWR – 8 Years Kim Behnke, MWR – 7 Years Sara Hakes, CYF – 4 Years Heather Turnmire, CYF – 2 Years Marie Moua, CYF – 2 Years MaryAnn Haug, ADRC – 2 Years Rita Fehr, MWR – 2 Years Tara Reitan, CYF – 2 Years Sydney Brown, CYF – 1 Year Page 31 of 37 3 Division Updates Aging & Disability Resource Center (ADRC) • A part-time Administrative Assistant position is currently open at the ADRC front desk, with applications accepted through September 20. • Following the closure of our previous Café 60 provider, we have partnered with Pink Highland Café in Lake Holcombe to maintain a restaurant-model senior dining option in an area of the county that does not currently have a congregate meal site. • Our Elder Benefit Specialist (EBS) and EBS Assistant are preparing for the upcoming Medicare Open Enrollment period, with nearly 50 information packets mailed to previous clients known to need ongoing assistance, in addition to assisting new and returning clients throughout the enrollment period. Children, Youth & Families (CYF) Division Birth to Three (B-3) • Birth-to-Three had 15 referrals in the month of August. The team completed their Annual State Audit with MetaStar and are awaiting the final results coming at the end of September 2026. • Birth-to-Three is just wrapping up with some community outreach. The team put together information about making referrals to the Birth-to-Three Program and brochures for medical providers to share with families about the program. The team delivered these to over 100 medical providers in the area that have made Birth-to-Three referrals or specialize in pediatrics. • The team continues to be busy with referrals and the number of families they serve. Child Protective Services (CPS) • In August 2026, the Department received seventy-three reports alleging Child Abuse and/or Neglect; of those reports, twelve met the State Statute definition to screen in to complete an assessment. An additional five reports were screened in to offer services. • In August 2026, no cases were closed. • In August 2026, no children were reunified. • In August 2026, three children were removed from their parental home due to severe malnourishment and neglect. Unfortunately, there is no family available to take placement, and the children were placed in foster care, together. • In August 2026, Child Protective Services helped host the National Night Out Table for DHS and hosted their Annual Foster Care Picnic! Several families attended and enjoyed an evening of food, a resource scavenger hunt, backpacks, and door prizes! Children with Differing Abilities (CWDA) • Anna Ernstmeyer will be joining the Children’s CCS team on September 14th. We are very excited to have her join the CCS team! Page 32 of 37 4 • Keara Patrow and Sebastian Javier will be joining the CLTS team on September 14th (Keara) and September 28th (Sebastian). They will both be great additions to the CLTS team! • Remediation for the CLTS MetaStar audit was completed. We are anticipating final results by the end of the month. • Supervisors and staff continue preparation for changes coming with the 2027 Waiver Renewal. • The CCS Team attended the Crisis Training on August 18th. Youth Justice (YJ) • Kerry Krista was nominated for and will be receiving the WJCIA Frank Chrisafi Recognition Award for her years of impactful service in Youth Justice. She will receive the award at the WJCIA Conference at the end of September. • We have been working on updating on call information and procedures. • Amanda, Manda and Kyra will be meeting with the schools to collaborate on truancy prevention. Economic Support (ES) Division • Economic Support is currently recruiting 2 Economic Support Specialists, with an anticipated start date of 10/26. • Great Rivers Consortium recently completed the annual Management Evaluation Review. 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). Great Rivers scored well, with only 4 findings: 1. Upon DHS review of 25 Call Quality Reviews (CQR’s): the FS Reporting Requirements script was not read for all calls with a FoodShare interview conducted.  On 2 out of 25 calls the reporting requirement script was not read as required per policy. 2. The importance of setting the Filing Date was not always explained to customers expressing food insecurity:  On 3 out of 10 Anonymous calls, staff did not explain the importance of establishing a filing date when applying 3. FSQC Error Reports show 6 Active and 12 CAPER errors:  Active payment error rate of 6.86%, with errors totaling $1,199 due to: i. Wages and Salaries ii. Household Composition iii. Child Support Payments Received from Absent Parent  CAPER error rate of 20.00%, with errors due to: i. Verification ii. Notices iii. Wages and Salaries Page 33 of 37 5 4. The agency websites should be updated with additional information about the FoodShare program to include updated hyperlinks and the four ways to apply for benefits. • WI was the only state in the Midwest to score below 6% • WI scored #1 with Case and Procedural Errors (CAPERS) for states in the Midwest Mental Wellness & Recovery (MWR) Division • On August 6th the MWR division had a ½ day wellness and team building event. We are scheduled to have a staff development day on September 15th, which includes motivational speakers, leadership training and team building. • August 13-14 the MWR manager and 2 clinicians participated in the System Intercept Mapping for Chippewa County and joined committees which will be following up on goals set by the community providers and leaders. • August 18 th some of the MWR staff attended the annual fall Crisis Training provided by the WRRWC. • September 21: International Day of Peace — Devoted to strengthening the ideals of peace across all nations. Adult Protective Services (APS) • In August the opening number of APS cases was 87 and an additional 29 APS cases were opened, with total served equaling 116. During the first week of September there were 5 new admissions to the APS program. Currently there are 13 guardianship requests – 6 of which are in process and 7 new referrals. The requests for guardianships greatly exceed our staff capacity. Community Support Program (CSP) • The CSP program has been maintaining services for participants in the program; the daily staffing and increased team approach has improved participant services and outcomes. There was one new admission to CSP in August, and the team is working on 2 additional referrals in early September. Comprehensive Community Services (CCS) • A new adult CCS staff member, Erin Dewitz, has been hired and will begin employment on September 28, 2026. She will be a wonderful addition to the team!!! Lauren Eckhardt will return from maternity leave on September 15 th, and we are glad for her return also. The CCS workers had additional training from Crisis clinician, David Pfeiffer, on creating and updating crisis plans for participants. The CCS wait list is at 31, and all of them have had an outreach meeting to get the process started; this reflects a decrease in individuals on the wait list and soon we will have 2 additional workers to complete CCS enrollments. • Many CCS staff have registered for the annual Mental Health and Substance Abuse Recovery conference in October 2026. Page 34 of 37 6 Emergency Mental Health Services (aka Crisis) • During the 3rd quarter of 2026 there has been one emergency detention and 40 total crisis cases for minors. In the 3rd quarter there were 23 emergency detentions and 241 total crisis cases for adults. Cases increased from July to August and it is anticipated that cases will continue to grow during the fall months. • September 17-18 the Crisis Team will be attending the annual crisis conference in WI Dells. Page 35 of 37 Measure Jan. Feb. Mar. Apr. May Jun. Jul. Aug. Sept. Oct. Nov. Dec. Status Trend Aging & Disability Resource Center Benefit Specialists: Caseload 188 191 199 173 203 174 183 - ↑ Nutrition: Meals Served 2,231 2,679 2,888 2,880 2,661 2,814 2,746 - ↓ Options Counseling: Consumers Served 235 216 255 254 255 249 301 - ↑ Children, Youth, & Families Birth to 3: Referrals 17 27 21 21 11 18 21 15 ↓ Child Protective Services: Reports Received 100 91 88 83 60 63 72 72 --- Child Protective Services: Screened-In Reports 21 25 17 14 15 11 17 12 ↓ Children w/ Differing Abilities: Cases Opened 13 7 22 18 18 19 14 14 --- Children w/ Differing Abilities: Waitlist: Screening 21 22 Not avail. 32 24 17 16 14 ↓ Children w/ Differing Abilities: Waitlist: CCS 1 2 Not avail. 0 2 1 5 0 ↓ Children W/ Differing Abilities: Waitlist: CLTS 6 5 Not avail. 3 4 3 6 11 ↑ Youth Justice: Referrals 17 27 34 44 40 25 - - ↓ Economic Support Great Rivers Consortium: Average Speed of Answer 8.64 7.21 5.33 5.41 4.44 5.02 5.89 - ↑ Great Rivers Consortium: Calls Received 15,054 13,323 13,893 12,687 12,352 13,718 13,124 - ↓ Great Rivers Consortium: Caseload 61,796 61,190 60,870 61,023 61,023 60,583 60,722 - ↑ Great Rivers Consortium: FNS Error Rate 6.86% 0.00% 43.07% 13.13% 10.86% 9.91% 8.52% - ↓ Mental Wellness & Recovery Adult Protective Services: Cases Opened - - - - - - - 29 Adult Protective Services: Total Caseload - - - - - - - 116 Adult Protective Services: Guardianship Requests - - - - - - - 13 Crisis Reports: Adult 269 110 114 99 88 114 119 101 ↓ Crisis Reports: Youth 20 23 22 43 37 23 15 23 ↑ Crisis Response: 51.15 Emergency Detention 10 7 13 10 8 6 11 10 ↓ 51.45 Alcohol Detox 0 0 0 0 0 1 0 0 --- 55 Emergency Protective Placement 1 1 0 0 0 1 1 0 ↓ Community Supports 15 20 21 23 24 24 19 27 ↑ Crisis Stabilization Placement 1 0 0 0 0 0 0 0 --- Directors Hold 0 0 0 0 2 0 0 0 --- Home Individually 52 23 33 23 12 18 15 20 ↑ Jail - Precautions 3 3 5 5 1 6 5 2 ↓ Jail - Precautions Not Recommended 7 5 2 6 7 10 4 3 ↓ Med Tx Primary 5 7 2 4 4 5 6 4 ↓ Mobile Worker Dispatched 11 7 7 2 3 4 5 6 ↑ Note (Other) 171 54 43 63 52 54 61 49 ↓ Referral (Law Enforcement) 0 0 0 0 0 1 0 0 --- Referral (Internal DHS) 0 0 0 0 0 0 1 0 ↓ Telephone Stabilization Plan 6 0 4 1 3 0 0 0 --- Voluntary Inpatient Hospitalization 7 6 6 5 6 3 5 3 ↓ Walk-In - Emergency Detention 0 0 0 0 0 3 0 0 --- Walk-In/Phone - Home Individually 0 0 0 0 1 1 1 0 ↓ YJ - Precautions Not Recommended 0 0 0 0 2 0 0 0 --- IMD Expenditures - YTD Adults 41,539$ - 332,925$ 356,166$ 417,785$ 480,631$ 486,437$ ↑ Children - - - 34,216$ 8,554$ 8,554$ 6,690$ ↓ Measure 2020 2021 2022 2023 2024 2025 2026 Status Trend Historical Data: YTD Comparison Child Protective Services: Screened In Reports 194 151 129 108 124 126 132 ↑ Out-of-Home Placements (Includes Kinship) 187 171 161 136 64 105 116 ↑ Youth Justice: Referrals (2-Month Delay) 138 134 146 147 111 130 187 ↑ Measure 1 FTE 1 FTE 1 FTE 1 FTE 1 FTE 0.5 LTE Total Youth Justice: Caseload Status Ongoing 13 15 9 5 42 Deferred Agreements 13 7 20 62 Measure 1 FTE 1 FTE 1 FTE 1 FTE 1 FTE 1 FTE 1 FTE 1 FTE 1 FTE Total Child Protective Services: Caseload Status Initial Assessment 11 10 8 Training Training 29 Ongoing 7 6 6 6 25 54 Reporting through August 2026 Chippewa County Department of Human Services Monthly Dashboard | September 2026 WCHSA Caseload Recommendations Initial Assessments: 11 cases per worker with no more than 6 new assessments per worker per month Ongoing: 10 cases per worker with no more than 15 children per worker Page 36 of 37 26,002,720$ Expenses Paid (Through August 31): 20,123,341$ 5,879,379$ Month Kinship Projected Cost 2026 Grant Amount Over/(Under) Month Amount Paid Monthly Grant Amount January 80 443,723$ January 2,168$ 36,977$ February 80 443,723 February 33,453 36,977 March 76 443,723 March 30,448 36,977 April 75 352,743 443,723 (90,980) April 28,422 36,977 May 75 367,548 443,723 (76,175) May 28,025 36,977 June 74 351,624 443,723 (92,099) June 23,996 36,977 July 74 348,600 443,723 (95,123) July 27,789 36,977 August 72 346,560 443,723 (97,163) August 27,859 36,977 September 443,723 September 36,977 October 443,723 October 36,977 November 443,723 November 36,977 December 443,723 December 36,976 Total: 202,160$ 443,723$ Month Out of Home* Out of Home** Projected Cost 2026 Budget Over/(Under) Month Amount Paid Monthly Grant Amount January 30 0 1,068,015$ January 449$ 89,001$ February 31 0 1,068,015 February 99,334 89,001 March 29 0 1,068,015 March 150,604 89,001 April 29 0 1,483,404 1,068,015 415,389 April 115,039 89,001 May 26 0 1,508,304 1,068,015 440,289 May 61,796 89,001 June 31 0 1,287,300 1,068,015 219,285 June 73,968 89,001 July 32 0 1,268,640 1,068,015 200,625 July 137,201 89,001 August 1,068,015 August 223,802 89,001 September 1,068,015 September 89,001 October 1,068,015 October 89,001 November 1,068,015 November 89,001 December 1,068,015 December 89,004 Total: 862,193$ 1,068,015$ Month Out of Home Projected Cost 2026 Budget Over/(Under) Month Amount Paid Monthly Grant Amount January 10 479,041$ January -$ 39,920$ February 7 479,041 February 14,425 39,920 March 11 479,041 March 43,981 39,920 April 9 499,129 479,041 20,088 April 38,229 39,920 May 12 580,959 479,041 101,918 May 67,978 39,920 June 9 531,915 479,041 52,874 June 19,876 39,920 July 13 539,256 479,041 60,215 July 58,899 39,920 August 479,041 August 127,576 39,920 September 479,041 September 39,920 October 479,041 October 39,920 November 479,041 November 39,920 December 479,041 December 39,921 Total: 370,964$ 479,041$ Month Inpatient Days Projected Cost* 2026 Budget Over/(Under) Month Amount Paid Monthly Grant Amount January 119 765,000$ January -$ 63,750$ February 111 765,000 February 41,539 63,750 March 163 1,331,701 765,000 566,701 March 160,415 63,750 April 121 1,171,148 765,000 406,148 April 89,349 63,750 May 131 1,023,213 765,000 258,213 May 135,036 63,750 June 79 978,370 765,000 213,370 June 62,846 63,750 July 68 845,360 765,000 80,360 July 46,404 63,750 August 765,000 August 63,750 September 765,000 September 63,750 October 765,000 October 63,750 November 765,000 November 63,750 December 765,000 December 63,750 Total: 535,589$ 765,000$ July IMD is the latest 2026 invoice received *Children and Youth in Placement: Foster Care, Treatment Foster Care, Group Home, Residential Care **Additional children placed with relatives (unpaid) 2026 Adult Mental Health CBRF Out-of-Home Placements 2026 Adults in CBRF Placement 2026 Institute for Mental Disease (IMD) Placements 2026 IMD Note: Projected cost is based on the actual amounts paid in months where payments have been made, extrapolated to the rest of the year. Due to a lack of data related to 2026, projections will begin when the first quarter payments are complete. Note: The following reports show monthly disbursement amounts for each placement category. The month shown is the month the invoice was paid (not the month the charge was 2026 Kinship Placement with a Relative 2026 Kinship 2026 Children and Youth in Out-of-Home Placements 2026 Children & Youth Placements Variance to Budget: Chippewa County Department of Human Services Fiscal Report | September 2026 Reporting through August 2026 2026 Budget (Total is $39,004,091): Prorated - 8 months Page 37 of 37