Agenda w/ attachments

AGENDA CONTINUES (PAGE 1 OF 2) September 4, 2026 HEALTH AND HUMAN SERVICES BOARD MEETING Douglas County Board of Supervisors Thursday, September 10, 2026, 4:00 p.m., Government Center Boardroom 201 1316 North 14th Street, Superior, Wisconsin www.microsoft.com/microsoft-teams/join-a-meeting | Meeting ID: 264 432 389 614 | Passcode: 7fcuYq Or call-in: 1 872-242-8028 | ID: 190 782 896# Douglas County Health and Human Services Department Mission: To promote the health, safety, and well-being of individuals and families Please call 715-395-1304 or 715-395-1569 if you cannot attend. MEMBERS: Kelly Peterson, Chair Alan Jaques, Vice Chair Lee Sandok Baker Amida Gallito, M.D. Sue Hendrickson June Farkas, R.N. Marquise Slay Jim Bolin A G E N D A Virtual attendance available to public; committee members must attend in-person to constitute a quorum and/or vote. Committee to maintain a two-hour meeting limit or take action to continue meeting beyond that time. All action items include attachments unless noted. 1. ROLL CALL 2. PUBLIC PARTICIPATION FOR 2027 HHS BUDGET 4:00 PM-4:30 PM 3. APPROVAL OF MINUTES a. May 14, 2026 * 4. NEW STAFF INTRODUCTION(S) 5. UPDATES AND REPORTS*: Client data, staffing patterns, and current projects. a. V eterans Services e. ADRC b. Mental Health/AODA f. CLTS c. Intake & Assessment g. Economic Support d. Youth & Family Services h. Public/Environmental Health 6. ACTION ITEMS a. Budget Proposal Presentation for 2027 i. Veteran’s Office ii. Health & Human Services b. Opioid Settlement Funding Request – Child Welfare $150,000 7. INFORMATIONAL ITEMS a. 2026 Budget Update 8. FUTURE AGENDA ITEMS 9. ADJOURNMENT * Attachment included Notice is hereby given that a majority of the members of the Douglas County Board of Supervisors may be present at the meeting, and although this may constitute a quorum of the County Board of Supervisors, the County Board will not take any action at this meeting. This meeting will be recorded. By attending, you acknowledge that your image, voice, or comments may be captured on a public recording and made available to the public. Allowing public comment at committee meetings and the length of time for comments is at the discretion of the Committee Chair. (Resolution #38-24) cc : Interested Parties NO TE: Agenda and attachments available on www.douglascountywi.org or in County Clerk's Office. Action may be taken on any item on the agenda. The County of Douglas complies with the Americans with Disabilities Act of 1990. If you are in need of accommodation to participate in the public meeting process, please contact the Douglas County Clerk's Office at (715) 395-1341 by 4:00 p.m. on the day prior to the scheduled meeting. Douglas County will attempt to accommodate any request. TDD (715) 395-7521. AGENDA COMPLETE (PAGE 2 OF 2) 09/04/2026 Posted: Courthouse, Government Center, Superior Telegram, Superior Public Library ___ ___________________________________________________________ Name Date Page 1 of 2 HEALTH AND HUMAN SERVICES BOARD MEETING Douglas County Board of Supervisors Thursday, May 14, 2026, 4:30 p.m., Government Center Boardroom 201 1316 North 14th Street, Superior, Wisconsin Meeting called to order by Chair Peterson. 1. ROLL CALL Present – Kelly Peterson, Alan Jaques, Dennis Cummings, June Farkas, Jim Bolin (arrived 4:32). Absent – Marquise Slay, Amida Gallito. Others present – Mark Liebaert, Shelley Nelson, Dave Longsdorf, Stacie Buchanan, Holly VanKempen, Erika Johnson, Erick Hudson, Kathy Ronchi, Cindy Ellefson, Amy Brunette, Nikole Strand, Abbey Whetsel, Kaelyn Heintz, Alyssa Bonner, Chrissy Barnard, Bill Whiteside, Lexi Klasen (Committee Clerk). 2. APPRO VAL OF MINUTES Motio n by Jaques, second Cummings, to approve minutes of March 26, 2026, meeting. Motion carried. 3. INTRO DUCTION OF NEW STAFF Carson E ngel, Aaron Huber (Social service aids), Nikole Strand (CPS Ongoing Social Worker), Abbey Whetsel, Alyssa Bonner (IA Case Managers), Kaelyn Heintz (Disability Benefit Specialist), introduced. 4. UPDATE S AND REPORTS The foll owing departments reported on departmental activities: Veterans Services, Mental Health/AODA, Intake & Assessment, Youth & Family Services, ADRC, CLTS, Economic Support and Public/Environmental Health. 5. ACTIO N ITEMS a. Opioi d Settlement Funding Request – Funding Hope Haven Peer Respite – minimum of $190,000: Hope Haven requesting funding to continue full-time operations for 2026. Funding this program is an appropriate use of money; individuals serviced through program meet requirements of settlement funds. ACTI ON (REFERRAL): Motion by Jaques, second Cummings , to approve request and refer to Administration Committee. Motion carried unanimously. b. Opioi d Settlement Funding Request – Funding Safe Needle Disposal for City Parks – $486.14: City Parks and Recreation requested safe disposal box es for restrooms at city parks ; needles have been found around parks. 14 restrooms to be equipped with boxes, City to manage emptying boxes. ACTI ON (REFERRAL): Motion by Cummings , second Farkas, to approve request and refer to Administration Committee. Motion carried unanimously. 6. INFORM ATIONAL ITEMS a. 2026 budget updat e: Budget included in agenda through March 2026, and end of year 2025 budget. 2025 budget ended about $300,000 under budget. 2026 trending over budget, higher cost placements, higher revenue throughout summer will help balance budget. RETURN TO AGENDA Page 2 of 2 7. FUTURE AGENDA ITEMS None. 8. ADJO URNMENT Motion by Farkas, second Jaques, to adjourn. Motion carried. Meeting adjourned at 5:09 p.m. Submi tted by, Lexi K lasen, Committee Clerk RETURN TO AGENDA VSO Status Health & Human Services Committee September 2, 2026 Veterans Service Office Douglas County, WI As of: September 2, 2026 1 Erick Hudson Veteran Service Officer 1316 N. 14th Street, Rm385 Superior , WI 54880 715-395-1367 Erick.Hudson@douglascountywi.org RETURN TO AGENDA Douglas County Veteran Service Officer - Financial Management As of: September 2, 2026 The Douglas County VSO will: responsibly manage limited resources and ensure budgeted funds meet the needs and purpose of the Veteran Service Office. ObjectiveErick HudsonOwner: To ensure we are within our target budget for CY2026.Key Initiatives: Financial ManagementMeasure: 2 0 50 100 150 200 250 300 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Thousands VSO Operating Costs Budget ActualDate 2026 Budget Actual Monthly Jan 22,091.50 $ 24,654.79 $ Feb 22,091.50 $ 21,304.70 $ Mar 22,091.50 $ 21,825.23 $ Apr 22,091.50 $ 22,995.57 $ May 22,091.50 $ 4,679.78 $ Jun 22,091.50 $ 25,065.48 $ Jul 22,091.50 $ 18,758.69 $ Aug 22,091.50 $ 16,073.70 $ Sep 22,091.50 $ Oct 22,091.50 $ Nov 22,091.50 $ Dec 22,091.50 $ Douglas County Veteran Service Officer - Financial ManagementObjectiveKey Initiatives:Financial ManagementOwner:Measure:Erick HudsonT o ensure we are within our target Revenue for CY26.The Douglas County VSO will: responsibly manage limited resources and ensure budgeted funds meet the needs and purpose of the Veteran Service Office.Date # WDVA, CVSO GrantRevenues to DateTarget = $20,750Actual = $17,690Variance =$3,0603 As of: September 2, 2026 0510152025JanFebMarAprMayJunJulAugSepOctNovDec ThousandsRevenueBudgetActualDate 2026 Budget Actual MonthlyJan 812.50 $ - $ Feb 812.50 $ 2,790.00 $ Mar 812.50 $ - $ Apr 11,812.50 $ 500.00 $ May 812.50 $ 14,400.00 $ Jun 812.50 $ (1,050.00) $ Jul 812.50 $ 1,840.00 $ Aug 812.50 $ - $ Sep 812.50 $ - $ Oct 812.50 $ - $ Nov 812.50 $ - $ Dec 812.50 $ - $ Douglas County Veteran Service Officer - Financial ManagementThe Douglas County VSO will: responsibly manage limited resources and ensure budgeted funds meet the needs and purpose of the Veteran Service Office.ObjectiveErick HudsonOwner:Monitor Outreach and Transportation costs for CY26.KeyInitiatives:Financial ManagementMeasure: 4 As of: September 2, 2026 0123456789JanFebMarAprMayJunJulAugSepOctNovDec ThousandsOutreach & TransportationBudgetActual2026 Budget Actual MonthlyJan 654.17 $ - $ Feb 654.17 $ - $ Mar 654.17 $ 182.72 $ Apr 654.17 $ - $ May 654.17 $ 693.70 $ Jun 654.17 $ 163.10 $ Jul 654.17 $ 284.21 $ Aug 654.17 $ 122.33 $ Sep 654.17 $ - $ Oct 654.17 $ - $ Nov 654.17 $ - $ Dec 654.17 $ - $ Date: September 2026 Adu lt Services Unit Update Submi tted by: Dave Longsdorf 2025/2026 Jan Feb Mar April May June July Aug Sept Oct Nov Dec Drug Court Participants 7/12 9/12 10/12 10/12 10/11 10/11 10/10 10/10 Emergency Detentions 5/3 4/2 4/5 3/3 2/3 4/2 6/3 0/4 Commitments (Ch 51) Monthly total / Total on 51 5/2 6/1 1/5 3/7 1/7 2/7 1/5 3/5 Children’s Commitments Monthly total/total on 51 0/1 0/2 0/1 0/1 1/2 1/2 1/1 1/1 # Adults in Institutions 1/3 4/3 4/4 5/5 2/3 3/3 3/4 2/3 MH CBRF Placements 27/26 26/26 27/26 26/28 25/29 25/28 24/28 24/27 Referrals by Type: Mental Health Services 13/35 13/21 20/32 29/36 28/29 35/40 24/14 19/27 MH Case Management Assigned (51’s + brief service) 5/12 5/7 11/9 9/8 7/11 9/12 3/4 3/13 AODA Services 4/7 5/7 6/15 10/8 3/10 7/6 4/7 6/17 AODA Case Management Assigned 2/2 2/3 2/4 3/3 1/3 2/2 0/2 1/6 # on Waiting Lists Chronic Mental Illness 10/9 10/9 9/10 4/11 5/7 5/7 5/8 6/8 Number of Clients Served by Contract Mental Health CSP – Bright Water 117/ 118 117/ 118 111/ 118 112/ 118 113/ 118 114/ 118 114/ 118 114/ 118 AODA Inpatient CBRF 2/1 0/0 1/1 1/1 0/2 1/2 0/2 1/3 IDP – DUI Assessment 16/8 14/11 15/16 13/12 16/15 13/18 16/17 15/14 Detox Services 19/11 9/9 5/7 7/8 6/8 5/6 7/8 5/* Total Served 227/ 250 221/ 241 231/ 265 223/ 253 220/ 252 235/ 264 213/ 227 203/ 254 MH – M ental Health AODA – Alcohol and Other Drug Addictions HDC – Human Development Center, Douglas County LSS – Lutheran Social Services CBRF – Community Based Residential Facility IDP – Intoxicated Driver Program DUI – Driving under the influence * identifies insufficient/incomplete data RETURN TO AGENDA Chapter 51 Receiving a medical home 45.0%50.0%55.0%60.0%65.0%70.0%75.0%80.0%85.0%90.0%95.0%100.0% Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Goal 90 90 90 90 90 90 90 90 90 90 90 90 2026 100 100 100 100 100 100 100 100 Residents with mental health concerns frequently require specialized psychotropic medication to maintain good mental health. Psychotropic medication requires consistent follow up by medical professionals, as there can be side effects and the need for adjustments. There is currently a national shortfall in psychiatry. Primary medical physicians are increasingly called upon to provide medication prescription and follow up. The benefit of a primary physician is the holistic approach of addressing both the mental health concerns and physical wellness. Those clients currently under Chapter 51 commitment will be established with a primary medical provider. Chap ter 51 Clients Moved to a setting established by the physician as least restrictive within 5 days of the determination 45.0%50.0% 55.0% 60.0% 65.0% 70.0% 75.0% 80.0% 85.0% 90.0% 95.0% 100.0% Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Goal 100 100 100 100 100 100 100 100 100 100 100 100 2026 100 100 100 100 100 100 100 100 Individuals under Chapter 51 are under constant evaluation by the providers they are engaged with. Once a determination is made that the individual may be transferred to a placement that is less restrictive, case management staff will facilitate the change of placement within 5 days. This is done to promote the welfare of the individual under Chapter 51 and ensure fiscal responsibility to the county. RETURN TO AGENDA Intoxicated Driver Program Case Completions 45.0%50.0%55.0%60.0%65.0%70.0%75.0%80.0%85.0%90.0%95.0%100.0% Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Goal 85 85 85 85 85 85 85 85 85 85 85 85 2026 100 100 100 92 100 100 93 100 The Intoxicated Driver program (IDP) is a statutory program per HFS 62. A Drivers Safety Plan must be developed by an IDP assessor to determine what steps are necessary for the citizen to recover their driver’s license after an OWI/DUI. A case completion is a resident who has completed all recommendations and has been reinstated with their driver’s license. Adult Protection 2025/2026 Jan Feb March April May June July Aug Sept Oct Nov Dec # of Cases 45/45 44/32 52/46 36/46 50/49 46/39 39/36 27/51 Ch. 54 Guardianships 3 3 4 3 3 0 2 2 All Adult Protection cases received attention within the statutory 24 hour timeline RETURN TO AGENDA Use of Corporate Guardian (New Guardianships assigned to natural supports vs corporate guardianship) 0.0%5.0%10.0%15.0%20.0%25.0%30.0%35.0% 40.0% 45.0% 50.0% Jan FebMar Apr MayJune July Aug Sept Oct Nov Dec Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Goal 5 5 5 5 5 5 5 5 5 5 5 5 2026 0 0 50 33 33 0 0 50 Adult Protection works with friends and families (referred to as natural supports) of the identified ward, to determine a suitable guardian. A guardian appointed who has a personal connection to the proposed ward is best practice. When a suitable friend or family member is not identified or unavailable, a corporate guardian is used. A corporate guardian is typically an agency who performs guardianship tasks for payment. Investigated Adult Protection cases entered into state reporting system 45.0%50.0%55.0%60.0%65.0%70.0%75.0%80.0%85.0%90.0%95.0%100.0% Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Goal 100 100 100 100 100 100 100 100 100 100 100 100 2026 100 100 100 100 91 91 91 62 Adult protection cases investigated must be entered into the state reporting system (WRAPS) within the calendar year. The adult services unit has a standard of entering the data into WRAPS within 30 days. The graph is adjusted on each report to account for completed data entry if within the 30 days. 2026 Goals Jan Feb Mar April May June July Aug Sept Oct Nov Dec 1. CH. 51 clients will receive a medical home. 2/2 1/1 1/1 3/3 1/1 2/2 1/1 3/3 2. CH. 51 clients will be moved to a least restrictive placement within 5 days of determination. 2/2 1/1 1/1 3/3 1/1 2/2 1/1 3/3 3. Successful IDP Completion 16/16 14/14 15/15 12/13 16/16 13/13 15/16 15/15 4. Guardians Assigned (natural support vs corporate) 3/3 3/3 2/4 1/3 2/3 0/0 2/2 1/2 5. Investigated APS cases entered into state system. 45/45 32/32 46/46 46/46 45/49 42/46 33/36 32/51 Child Welfare Unit - Intake and Assessment and Foster Care/Kinship Health and Human Services Board Update September, 2026 Board Report Submitted by: Cindy Ellefson, Child Welfare Director on September 1, 2026 2025/2026 ref errals by type: 2025/2026 Jan Feb Mar April May June July Aug Sept Oct Nov Dec 25/26 25/26 25/26 25/26 25/26 25/26 25/26 25/26 25/26 25/26 25/26 25/26 Referrals by Type: Cases Assigned Screened In cases # o f victims 18/17 26/22 13/16 14/29 22/22 28/31 13/20 15/31 13/20 14/17 8/19 8/30 18/24 31/42 15/ 27/ 22/ 36/ 24/ 37/ 21/ 28/ 19/ 32/ Physical Abuse # of re ports # of victims 4/6 4/6 7/6 7/6 5/3 5/3 7/6 7/7 3/2 4/2 2/8 2/8 6/8 6/11 6/ 8/ 8/ 9/ 5/ 5/ 9/ 9/ 6/ 7/ Neglect # of reports # of victims 9/8 13/11 6/11 7/22 13/13 19/18 49/4 47/4 8/10 8/12 5/13 5/24 14/19 25/33 10/ 19/ 12/ 23/ 16/ 29/ 11/ 17/ 12/ 23/ Sexual Abuse # of reports # o f victims 5/3 6/5 0/2 0/2 4/6 4/7 2/4 2/5 2/2 2/2 2/1 2/1 1/1 1/1 0/ 0/ 2/ 3/ 4/ 4/ 1/ 1/ 2/ 2/ Emotional # of reports # of victims 2/0 4/0 0/0 0/0 0/2 0/4 1/0 1/0 0/0 0/0 0/0 0/0 0/1 0/2 0/ 0/ 1/ 1/ 2/ 2/ 0/ 0/ 0/ 0/ Screened out reports 48/67 43/77 62/69 61/67 60/57 38/46 38/46 38/ 66/ 64/ 53/ 62/ RETURN TO AGENDA Initial Assessment 60 Day Completion 2026 The standard for the state is 90% of intake assessments are completed and approved within the 60-day required time frame. 45.0% 50.0% 55.0% 60.0% 65.0% 70.0% 75.0% 80.0% 85.0% 90.0% 95.0% 100.0% Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec State Standard 90 90 90 90 90 90 90 90 90 90 90 90 Douglas County 96 96 100 96 100 100 100 100 • This has been an area of growth, and we will continue to put this as a focal point in 2026. Face to Face Response Times (attempted and completed within the response time) 45.0%50.0%55.0%60.0%65.0%70.0%75.0%80.0%85.0%90.0%95.0%100.0% Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Jan Feb Mar Apr MayJune July Aug Sept Oct Nov Dec State Standard 95 95 95 95 95 95 95 95 95 95 95 95 Douglas County 85 82 89 73 88 87 93 *Not c ompleted due to providers that are unavailable to meet due to not being home or staff having incomplete demographic information, and/or non-cooperative care providers. Extenuating circumstances at times drives this number below the expected average. However, we’ve had some great numbers the last couple months. RETURN TO AGENDA Foster Care, Court Ordered Kinship Care and Voluntary Kinship Care 2025/2026 Jan Feb Mar April May June July Aug Sept Oct Nov Dec Licensed Foster Care Homes* 43/40 44/40 44/40 45/39 45/39 47/39 47/40 47/ 43/ 43/ 43/ 41/ Level One Foster Care Homes* 1/1 1/1 1/0 1/0 1/0 1/0 1/0 1/ 1/ 1/ 1/ 1/ Kinship Cases Volunteer* Court ordered* 75/74 6/3 75/74 5/2 74/70 6/1 74/67 6/1 74/69 2/2 74/67 3/5 74/65 2/4 74/ 4/ 68/ 6/ 71/ 6/ 76/ 6/ 72/ 4/ ICPC** providers Licensed by another state 4/3 4/4 4/4 5/4 8/5 8/5 8/5 8/ 6/ 6/ 6/ 9/ *Foster Home – any facility that is operated by a person required to be licensed by S. 48.62 (1). * Level One Foster Home – licensed provider who cares for a child specific relative. *Volunteer Kinship - program describer under S. 48.57 (3m) which provides specific assistance *Court Ordered Kinship Care – when the placement of a child with relatives becomes ordered by the court. **Interstate Compact on the Placement of Children (ICPC) Chi ld Care Certification 2025/2026 Jan Feb Mar April May June July Aug Sept Oct Nov Dec Child Care Certification 3/3 3/3 3/3 3/3 3/3 3/3 3/3 3/3 3/ 3/ 3/ 3/ Certified Child Care home: A residence in which the certified childcare operator provides care of children, and which meets the standards under DCF 202.08 for reimbursement of care by county or tribal agencies. RETURN TO AGENDA Child Welfare Unit – Child Protective Services Ongoing and Youth Justice Health and Human Services Board Update September 2026 Board Report Submitted by: Cindy Ellefson, Child Welfare Director on September 1, 2026 2025/2026 ref errals by type: Types of Service 2024/ 2025 Jan 25/2 6 Feb 25/26 March 25/26 April 25/26 May 25/26 June 25/26 July 25/26 Aug 25/26 Sept 25/26 Oct 25/26 Nov 25/26 Dec 25/26 Juvenile Court Referrals 8/1 8/13 21/27 17/27 11/17 6/12 5/20 7/11 17/ 8/ 14/ 14/ Type: TPC 1/0 2/1 7/10 4/10 5/6 0/6 2/8 5/5 6/ 0/ 8/ 6/ Drug / Alcohol 1/0 0/1 0/0 3/0 0/0 0/0 0/1 0/0 2/ 0/ 0/ 0/ Disorderly Conduct 2/0 2/0 1/1 3 /3 1 /0 1/ 0 0/0 0/0 2/ 1/ 0/ 0/ Sexual Assault 0/0 0/1 0/2 0/0 0/0 2/2 1/0 0/0 0/ 1/ 0/ 0/ Truancy 1/0 1/6 0/2 3/4 3/3 0/0 0/1 0/0 0/ 4/ 5/ 2/ Battery 2/0 1/1 0/1 2/0 0/2 2/1 0/1 1/0 2/ 1/ 0/ 2/ Theft 0/0 0/0 0/1 1/0 0/0 0/0 0/0 1/1 2/ 0/ 1/ 0/ Burglary 0/0 0/0 0/0 0/0 0/0 0/0 0/0 0/0 0/ 0/ 0/ 0/ Stolen Vehicle 0/0 0/0 0/0 0/0 0/0 0/0 0/0 0/1 0/ 0/ 0/ 0/ Other: 1/2 2/3 13/10 1/10 2/6 1/3 2/9 0/4 3/ 1/ 0/ 4/ Total Caseload: Delinquenc y/ Status Offenders Conse nt Decrees 31/34 7/6 29/32 12/6 28/29 8/7 27/28 8/5 13/28 5/6 22/28 3/6 28/26 7/7 28/28 7/3 47/ 2/ 37/ 4/ 39/ 9/ 30/ 5/ RETURN TO AGENDA Deferred Prosecution 5/8 8/7 7/10 6/10 5/8 2/13 7/12 7/12 5/ 6/ 6/ 7/ CPS On- Going 78/68 76/68 77/70 78/69 80/68 78/69 76/68 75/ 77/ 75/ 76/ 76/ Electronic Monitor Days 62/60 39/11 0/62 9/85 0/97 0/53 10/57 14/39 0/ 0/ 30/ 77/ Secure Detention Days # of Youth 72 Hour Holds (# of Youth) 53/24 3/2 0/0 39/40 2/3 1/1 44/ 3/5 1/1 60/97 1/5 0/1 0/119 1/4 0/1 2/121 2/5 0/1 10/109 2/5 0/0 0/129 0/5 0/0 60/ 2/ 0/ 62/ 2/ 0/ 150/ 5/ 0/ 202/ 5/ 1/ Juveniles under Mental Health Commitme nt 0/2 0/2 0/2 1/2 1/2 1/2 1/2 1/3 1/ 1/ 1/ 1/ Independen t Living Services 9/11 10/15 7/12 5/13 15/14 13/14 12/16 12/16 10/ 10/ 12/ 12/ 45 50 55 60 65 70 75 80 85 90 95 100 Jan 22 Feb Mar Apr May June July Aug Sept Oct Nov Dec State Standard 95 95 95 95 95 95 95 95 95 95 95 95 Douglas County 100 100 100 100 100 98 100 Face to Face Contacts 2026 Social workers will successfully have face-to-face contacts with 95% or more of all children in out-of-home care on a monthly basis. 0 1 2 3 4 5 6 7 8 9 10 Jan 20 Feb Mar Apr May June July Aug Sep Oct Nov Dec State Standard 8.3 8.3 8.3 8.3 8.3 8.3 8.3 8.3 8.3 8.3 8.3 8.3 Douglas County 0 0 0 0 0 0 0 Re-Entry into Out of Home Care 2026 Of all children who achieved legal permanence, 8.3% or fewer re-enter out of home care within 12 months.. ADRC Report 2026 Date: September 2026 Submitted by: Stacie Buchanan, ADRC Director 1 ADRC – Purpose The Aging and Disability Resource Center (ADRC) of Douglas County serves residents of Douglas County who are 60 years of age or older, adults with physical/intellectual/developmental disabilities, or disabled children transitioning into adulthood, including helping families, friends, community members or professionals who surround these clients. The A DRC is the “Bridge to Support” by offering education provide information about aging and disability supports, local community resources, dementia, and public programs. ADRCs are voluntary in nature and provide options and choices while remaining confidential and unbiased. The ADRCs are paid by state contract to offer a set scope of services. This contract has core services we must offer: information and assistance, options counseling, benefits counseling, support on dementia, and functional screening for long term care benefits. This scope also has optional services that we may offer once core services are met. ADRC – Updates Staffing ADRC Team: • Director • 4.0 FTE for Information and Assistance (I&A) • 0.5 FTE Dementia Care Specialist (DCS) • 1 FTE Disability Benefit Specialist (DBS) State Updates 2030 Initiative: • A committee of ADRC leaders and the State ADRC Office of Resource Center Development has been formed to review expected growth in target populations by 2030 due to aging trends. • The group is working to identify changes and efficiencies within ADRCs to address challenges already being experienced. The ADRC is currently fully staffed. Hannah Ross has moved into our DCS/I&A position, Amber Osterlund was our half-time I&A and took a full-time I&A position. Kaden Bergman was hired for our half-time I&A position, which all occurred in the month of June. Initiatives the state staff or committees are currently working on: • Operational model and options • Artificial Intelligence Resource Committee • New or updated training • New time reporting system • Other Fiscal and Operational efficiencies RETURN TO AGENDA ADRC Report 2026 Date: September 2026 Submitted by: Stacie Buchanan, ADRC Director 2 ADRC – Clients Served *ADRC clients served are the number of unduplicated clients within that month and do not include DBS or EBS client numbers. **ADRC workers are required to record all Contacts. A contact represents an individual one -to-one interaction (conversation) that has occurred either in person, at a home visit, ADRC walk-in, telephone, email, or written correspondence where information is exchanged. Each interaction is counted as an encounter and will demonstrate one instance of providing any ADRC activity. Contacts include but are not limited to, providing information and assistance, follow up, options counseling, administering a functional Screen, assistance with Medicaid application process, short term service coordination, enrollment or disenrollment counseling, memory screens, complaints/advocacy, communicating with community partners, or taking referrals for ADRC. Number of Clients Served Jan 25/26 Feb 25/26 Mar 25/26 Apr 25/26 May 25/26 June 25/26 July 25/26 Aug 25/26 Sep 25/26 Oct 25/26 Nov 25/26 Dec 25/26 Total Number of ADRC Clients Served * 251/248 215/228 235/246 235/237 298/191 227/206 185/211 208/ 203/ 272/ 227/ 218/ Total Number of Contacts** 722/464 637/455 670/493 695/485 806/447 701/435 570/432 463/ 449/ 552/ 403/ 394/ Elderly Benefit Specialist (EBS) 11/13 9/9 11/5 11/7 20/5 10/14 21/11 17/ 16/ 41/ 20/ 19/ Disability Benefit Specialist (DBS) 23/15 25/8 31/8 24/8 28/8 25/17 21/20 20/ 23/ 23/ 22/ 20/ Memory Screens 2/2 5/1 4/0 0/0 5/0 15/1 1/1 0/ 0/ 1/ 10/ 5/ Number Served in Long Term Care Programs Jan 25/26 Feb 25/26 Mar 25/26 Apr 25/26 May 25/26 June 25/26 July 25/26 Aug 25/26 Sep 25/26 Oct 25/26 Nov 25/26 Dec 25/26 Long Term Care Functional Screens (LTCFS) Calculated 16/7 8/12 9/8 10/8 14/9 8/10 13/9 15/ 7/ 12/ 13/ 3/ Long Term Care Functional Screen active 24/18 16/20 19/17 25/19 29/14 24/19 30/19 21/ 15/ 26/ 22/ 14/ Long Term Care Enrollments 12/1 6/1 9/6 4/7 8/7 6/5 7/6 1/ 10/ 5/ 7/ 2/ Long Term Care Disenrollments 3/4 3/3 2/0 3/3 2/0 4/0 3/0 8/ 4/ 2/ 3/ 1/ ADRC Formal Complaints 0/0 1/0 0/0 0/0 0/0 0/0 0/0 0/ 0/ 0/ 0/ 1/ ADRC Report 2026 Date: September 2026 Submitted by: Stacie Buchanan, ADRC Director 3 Demographics of Clients Served (YTD) Age 28% 47% 25% Under 60 60 and older Unknown Living Arrangement 51% 40% 3% 2%4% Alone LTC Facility With others Not Requested Unhoused Service Type by Clients 6% 11% 2% 7% 22% 52% I&A MA assistance Options Counseling DCS Services Other Functional Screens Service Type by Time (July 2026) **Does not include EBS 19% 4% 8% 0% 10% 8% 10% 19% 22% I&A MA assistance Options Counseling DCS Services Other Functional Screens Time off DBS Training Demographics of clients served do include DBS and EBS clients. Unknown age or living arrangements include anonymous clients or family, friends, or professions calling for general information when living arrangement or age was not available or unknown. ADRC Report 2026 Date: September 2026 Submitted by: Stacie Buchanan, ADRC Director 4 Functional Screening Information and assistance positions may perform functional screening for Medicaid Long-Term Care programs. This process of enrolling may take one to three months in most cases. The ADRC is the gatekeeper to this program as the screening will determine an individual’s needs for daily living to determine if the individual is at a nursing home level of care. If an individual is at a nursing home level of care and they can qualify for a full benefit Medicaid through Economic Support, then the individual can enroll for services within their home or community living space. This allows individuals to remain in the community and out of Nursing Homes or Skilled Nursing Facilities. ADRCs also perform the non-biased enrollment and disenrollments for these programs. Data for completed screens, enrollments and disenrollments are on the client served table. Marketing and Outreach Superior Telegram • Weekly advertising • Can advertise events or general services Senior Connections Newsletters • Annual payment for services advertisement in all newsletters Facebook • Creating and sharing events • Sharing relevant posts • Event advertising (low cost) Resource Guides • Updating with state • Updating guides regularly • Electronic version for local websites Tabeling events Events/Conferences • August 6: 11-3 IndiGO Disability Celebration – SHS • August 25: 4-7 SHS Open House – SHS • September 16: 2-3 Resilient Caregiver – YMCA • September 21-23: ADILN Conference – WI Dells • September 24 & 25: DCS Conference – Madison • September 30: 10:30-12:30 Memory Café – SPL (Library) • October 8: DCS Group Presentation – SPL • October 11: 11-1 Douglas County Coalition on Transitions: Community Conversation – SPL • October 21: 1-2 DCS Dementia/ADRC Presentation – Essentia • October 28: 10:30-12:30 Memory Café – SPL (Library) ADRC Report 2026 Date: September 2026 Submitted by: Stacie Buchanan, ADRC Director 5 Alzheimer’s Family and Caregiver Support Program (AFCSP) AFCSP 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 Total Cases Served 8 6 8 7 14 13 9 9 9 10 10 **AFCSP removed financial eligibility from its program in August of 2025 with 2025 Wisconsin Act 21. AFCSP is available to individuals with a diagnosis of Alzheimer’s disease or other irreversible dementia and their caregiver when the person with dementia is living at home. The individual with the dementia/Alzheimer’s diagnosis cannot be eligible for Medicaid long- term care support programs. Program coordinators are required to approve all expenditures before families purchase goods or services using AFCSP funds. Because each family’s situation is different and changes over time, AFCSP coordinators may be asked to approve a wide range of goods and services. Approval of any service must be based on the participant’s needs assessment and approved service plan. Examples of use of funds include respite, caregiver self-care, supportive home care, adaptive equipment and assistive technology, recreation and social activities, transportation, congregate or home delivered meals, caregiver counseling, therapeutic services, education and training, and other goods and services necessary to maintain the individual as a member of the household. ADRC Report 2026 Date: September 2026 Submitted by: Stacie Buchanan, ADRC Director 6 ADRC Report 2026 Date: September 2026 Submitted by: Stacie Buchanan, ADRC Director 7 Children’s Long-Term Support Board Report – September 2026 July Data - Maximum of 45 calendar days to complete eligibility determination. ** State average – 27 days to complete eligibility determination July Data - Maximum of 45 calendar days to enroll once determined eligible. ** State average – 36 days to enroll once determined eligible RETURN TO AGENDA Children’s Long-Term Support Board Report – September 2026 July Data - Maximum of 90 days from initial referral to enrollment. ** State average – 54 days from initial referral to enrollment. Referrals & Current Enrollment Date 2024 Referrals 2025 Referrals 2026 Referrals Current Waitlist Total Enrolled to-date 8/31/26 73 80 43 0 178 Children’s Long-Term Support Board Report – September 2026 AGE GROUPS TARGET GROUPS Children’s Long-Term Support Board Report – September 2026 TARGET GROUP BY AGE GROUPS Great Riers Call Center 2022 • Aug ust not yet available IM Recipients- Douglas County 2026 • Aug ust not yet available Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Calls Presented 15,054 13,323 13,893 12,687 12,352 13,718 13,124 Calls Handled 13,503 12,080 12,979 11,743 11,556 12,725 11,938 0 2,000 4,000 6,000 8,000 10,000 12,000 14,000 16,000Number of Calls 2,000 4,000 6,000 8,000 10,000 12,000 Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Adults 5,676 5,674 5,653 5,644 5,615 5,614 5,633 Children 3,617 3,639 3,618 3,574 3,562 3,562 3,562 Total 9,293 9,313 9,271 9,218 9,177 9,176 9,195 Adults Children Total RETURN TO AGENDA Total Applications Processed Monthly 2026 • August not available Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec GRC 3,903 3,284 3,335 3,158 2,873 3,253 3,288 Douglas County 419 323 383 323 265 330 371 100 250 400 550 700 850 1,000 1,150 1,300 1,450 1,600 1,750 1,900 2,050 2,200 2,350 2,500 2,650 2,800 2,950 3,100 3,250 3,400 3,550 3,700 3,850 4,000 4,150 4,300 4,450 4,600 4,750 4,900 GRC Douglas County Douglas County Application Timeliness 2026 • August not available Data includes applications for FoodShare, Medical Assistance, Child Care and Caretaker Supplement. The Federal performance standard is 95% or more of applications are processed timely. 45.00% 50.00% 55.00% 60.00% 65.00% 70.00% 75.00% 80.00% 85.00% 90.00% 95.00% 100.00% Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec GRC 99.03 99.21 99.07 98.73 99.27 99.14 98.94 Douglas County 98.81 97.83 98.07 98.14 98.87 98.79 97.84 Economic Support Unit Date: 9/1/2026 Prepared By: Cary Breitlow Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2025 2440 2429 2425 2391 2357 2332 2294 2026 2256 2272 2299 2288 2270 2322 2417 Difference -184 -157 -126 -103 -87 -10 123 0 0 0 0 0 % Change -7.5% -6.5% -5.2% -4.3% -3.7% -0.4% 5.4% * August numbers not yet available Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2025 7300 7265 7116 6806 6547 6356 6171 2026 6560 6673 6652 6638 6764 6830 7010 Difference -740 -592 -464 -168 217 474 839 0 0 0 0 0 % Change -10.1% -8.1% -6.5% -2.5% 3.3% 7.5% 13.6% * August numbers not yet available Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2025 607 597 554 600 581 566 544 2026 572 570 605 556 566 577 604 Difference -35 -27 51 -44 -15 11 60 0 0 0 0 0 % Change -5.8% -4.5% 9.2% -7.3% -2.6% 1.9% 11.0% * August numbers not yet available Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2025 5103 5041 5084 5072 5061 4982 4916 2026 4902 4886 4889 4847 2804 2787 2790 Difference -201 -155 -195 -225 -2257 -2195 -2126 0 0 0 0 0 % Change -3.9% -3.1% -3.8% -4.4% -44.6% -44.1% -43.2% Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2025 98 98 114 2026 68 50 91 Difference -30 -48 0 0 0 -23 0 0 0 0 0 0 % Change -30.6% -49.0% -20.2% *July & August numbers not yet available **Report unavailable for 3/2026-5/2026 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2025 23 23 23 23 23 24 24 24 2026 25 23 19 19 18 18 18 17 Difference 2 0 -4 -4 -5 -6 -6 -7 0 0 0 0 % Change 8.7% 0.0% -17.4% -17.4% -21.7% -25.0% -25.0% -29.2% 2026 Shares (Child Care) Benefit Utilization Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec $60,236.35 $45,648.04 NA NA NA $81,642.90 *July & August numbers not yet available ***Report unavailable for 3/2026-5/2026 2026 FoodShare/SNAP Benefits Provided Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec $760,947 $750,004 $762,051 $743,111 $742,569 $738,382 $816,220 * August numbers not yet available Health & Human Services Board Report Caretaker Supplement Cases Childcare Cases (Number of Children) Other Medicaid Recipients Elderly & Disabled Recipients Food Share Recipients BadgerCare Plus Recipients RETURN TO AGENDA Cumulative Report Date Range: 01/01/2026 to 09/06/2026 Incident Jurisdiction Group: Douglas County Health Jurisdiction: Health Jurisdiction Date Type : Create Transmission Status: Outbreak Jurisdiction Group: Douglas County Resolution Status: Confirmed, Suspect Process Status: Prepared By: WEDSS (Preparer's Title) Telephone: 9885297959 Fax: 9848999801 All diseases except HIV and Lead Disease Name Number of Incidents ANAPLASMOSIS, A. phagocytophilum 8 ASBESTOSIS 5 CAMPYLOBACTERIOSIS 7 CARBON MONOXIDE POISONING 1 CHLAMYDIA TRACHOMATIS INFECTION 66 CORONAVIRUS, NOVEL 2019 (COVID-19) 111 CORONAVIRUS, NOVEL 2019 (COVID-19) - ASSOCIATED HOSPITALIZATION 11 CRYPTOSPORIDIOSIS 1 E-COLI, ENTEROPATHOGENIC (EPEC) 3 E-COLI, ENTEROTOXIGENIC (ETEC) 3 E-COLI, SHIGA TOXIN-PRODUCING (STEC) 1 ENTERIC-NOT REPORTABLE 4 GONORRHEA 7 HEPATITIS B, CHRONIC 1 HEPATITIS C, CHRONIC 11 INFLUENZA 141 INFLUENZA-ASSOCIATED HOSPITALIZATION 20 LEGIONELLOSIS 1 LYME DISEASE, ERYTHEMA MIGRANS (EM) RASH 31 MYCOBACTERIAL DISEASE (NON-TUBERCULOUS) 4 NOT REPORTABLE 13 PERTUSSIS (WHOOPING COUGH) 1 PESTICIDE-RELATED ILLNESS 2 Information contained on this form or report which would permit identification of any individual has been collected with a guarantee that it will be held in strict confidence, will be used only for surveillance purposes, and will not be disclosed or released without the consent of the individual in accordance with Section 308(d) of the Public Health Service Act (42 U.S.C. 242m). RETURN TO AGENDA Date Range: 01/01/2026 to 09/06/2026 Incident Jurisdiction Group: Douglas County Health Jurisdiction: Health Jurisdiction Date Type: Create Transmission Status: Outbreak Jurisdiction Group: Douglas County Resolution Status: Confirmed, Suspect Process Status: Prepared By: WEDSS (Preparer's Title) Telephone: 9885297959 Fax: 9848999801 All diseases except HIV and Lead Disease Name Number of Incidents PNEUMOCYSTIS JIROVECII 2 RESPIR ATORY SYNCYTIAL VIRUS (RSV) 3 RESPIRATORY SYNCYTIAL VIRUS (RSV) - ASSOCIATED HOSPITALIZATION 19 RESPIRATORY-NOT REPORTABLE 1 SALMONELLOSIS 3 STREPTOCOCCAL DISEASE, INVASIVE, GROUP A 2 STREPTOCOCCAL DISEASE, INVASIVE, GROUP B 6 STREPTOCOCCUS PNEUMONIAE, INVASIVE DISEASE 6 TOXOPLASMOSIS 1 TUBERCULOSIS, LATENT INFECTION (LTBI) 8 YERSINIOSIS 2 STI Disease Name Number of Incidents CHLAMYDIA TRACHOMATIS INFECTION 66 GONORRHEA 7 Enteric Diseases Disease Name Number of Incidents CAMPYLOBACTERIOSIS 7 C RYPTOSPORIDIOSIS 1 E-COLI, ENTEROPATHOGENIC (EPEC) 3 E-COLI, ENTEROTOXIGENIC (ETEC) 3 E-COLI, SHIGA TOXIN-PRODUCING (STEC) 1 Information contained on this form or report which would permit identification of any individual has been collected with a guarantee that it will be held in strict confidence, will be used only for surveillance purposes, and will not be disclosed or released without the consent of the individual in accordance with Section 308(d) of the Public Health Service Act (42 U.S.C. 242m). Date Range: 01/01/2026 to 09/06/2026 Incident Jurisdiction Group: Douglas County Health Jurisdiction: Health Jurisdiction Date Type: Create Transmission Status: Outbreak Jurisdiction Group: Douglas County Resolution Status: Confirmed, Suspect Process Status: Prepared By: WEDSS (Preparer's Title) Telephone: 9885297959 Fax: 9848999801 Enteric Diseases Disease Name Number of Incidents ENTERIC-NOT REPORTABLE 4 SALMONELLOSIS 3 YERSINIOSIS 2 Vaccine Preventable Disease Name Number of Incidents HEPATITIS B, CHRONIC 1 NOT REPORTABLE 13 PERTUSSIS (WHOOPING COUGH) 1 Outbreak / Investigations Outbreak / Investigation T ype Number of Outbreak / Investigations Foodborne Disease 14 Other 51 Waterborne Disease 2 Information contained on this form or report which would permit identification of any individual has been collected with a guarantee that it will be held in strict confidence, will be used only for surveillance purposes, and will not be disclosed or released without the consent of the individual in accordance with Section 308(d) of the Public Health Service Act (42 U.S.C. 242m). Douglas C ounty Department of Health and Human Services Public Health Nursing Services Board Report September 2026 General Public Health Nursing: Programs 2022 Total 2023 Total 2024 Total 2025 Total 2026 Total Immunizations YTD: # of Children Served # of immunizations(general) # of child seasonal flu shots # of Adults Served #of immunizations # Adult seasonal flu shots (homebound elderly/disabled) 6 13 1 10 15 3 5 15 0 6 8 1 4 10 2 6 13 1 2 2 0 7 7 3 0 0 0 4 2 2 TB Skin Tests Latent Tuberculosis (LTBI) – Reports and Follow-up LTBI-Active Case Mgmt Active TB Cases (YTD) 281 2 0 0 145 1 0 0 142 22 0 0 61 16 1 0 114 8 5 0 2026 Imm unization Objective: Because of the increasing number of measles cases nationwide and lower MMR vaccination rates in certain communities, one focus of the Immunization Program is to increase MMR rates. Our goal this year is to monitor MMR rates in school-age children, a vulnerable population should an outbreak occur. By the e nd of the fiscal year, the Douglas County Health Department will increase the percentage of children aged 6-8 who have received two doses of the MMR vaccine from 70% to 75% through targeted education, provider engagement, and community outreach. As of 8/2026, approximately 74% of eight-year-olds have received the recommended doses of the MMR vaccine. Outreach to families of children ages 6-8 who are not up to date has been completed, providing education and resources. RETURN TO AGENDA 2026 Childhood Lead Objective: Douglas County has some of the oldest housing stock in the state, many of which are rental units with families moving in and out regularly. Ongoing lead poisoning prevention education is vital in our community. Children at highest risk for lead poisoning are those living in high-risk neighborhoods, enrolled in the Medicaid or WIC Program, those living or spending time in pre-1950 housing or pre-1978 housing undergoing renovation, or those with a sibling or playmate with lead poisoning. At a minimum, age-appropriate blood lead tests are done at around 12 and 24 months, or at least once between three and five years if the child has no previous test documented. Ob jective: By December 31, 2026, Douglas County will increase the percentage of blood lead testing for 1- and 2-year-olds. Strategies: Contact providers in Douglas County and provide universal testing campaign materials. Mail out reminders to families with children under age three to get their child tested for lead. Participate in at least two outreach activities to provide community education on the importance of blood lead testing. Chi ldren in Douglas County will receive public health intervention services if their blood lead level is greater than or equal to 3.5 mcg/dL. Services include recommending venous confirmation of elevated capillary tests, providing lead poisoning prevention and treatment education, and offering environmental lead hazard home inspections of their primary residence and/or secondary properties where the child spends time. * In 2018, the upper threshold was reduced from 20 to 15. In 2022, the lower threshold was reduced from 5 to 3.5. 2026 Maternal Child Health Objective: Objective: Adolescent Mental Health By D ecember 31, 2026, the agency, in collaboration with community partners, will implement and evaluate strategies to improve mental health outcomes for youth or increase access to mental health services. Strategy 1: Collaborate with organizational partners and youth to plan and implement programs and policies that improve mental health outcomes for youth or increase access to mental health services. Other MCH Activities: Safe Sleep outreach and education. Child Death Review. Birth to 3 An average of 46 children receive Birth to 3 services each month. Areas of developmental concern have primarily been speech, physical development, sensory issues, and automatic qualifying conditions such as extreme prematurity and Down Syndrome. Services are provided in the child's natural environment, usually at home. This year, we added speech and occupational therapy positions to the team. Due to staff turnover, we are temporarily partnering with other providers to help meet needs while we recruit new staff. 2024-2026 Preventive Health and Health Services (PHHS) Goal: Implement community-based interventions related to preventing and reducing environmental health hazards and AODA prevention education and resources. • Activities for Substance Abuse Prevention will include collaborating with numerous community partners and co alitions to address these needs and continue efforts to make Douglas County a healthier place to live, work, and play. The Drug Prevention Coalition (DPC) of Douglas County meets monthly and focuses mainly on youth substance abuse prevention. The coalition has funding sources, including the Drug Free Communities Grant and the State Opioid Response Grant. They have purchased lock boxes, lock bags, Narcan, xylazine/fentanyl test strips, Deterra bags, and alcohol bottle locks for community outreach. The coalition partners with community organizations like Project Reach Out (Youth Drop In), Vivent Health, the Police Department, local schools and school groups, and community members. The coalition has completed many outreach events and educational efforts in the local community (substance-free events for youth and families, including Movies on the Island and a Mural project with the Bong Center; Drug Take Back; Narcan education; local billboards; outreach at community events and school conferences; etc.). Coalition website: https://www.dcdrugprevention.com/ The Mental Health Coordinated Community Response Team (MHCCR) meets quarterly to share community partnerships, outreach events, training, and resources. The coalition continues to maintain a Douglas County Resource page: http://douglascountyresource.com/ Northwest Lung Health Alliance (Tobacco Coalition) meetings, efforts and events focus on youth tobacco prevention. They hold a yearly youth wellness leadership summit bringing together local youth leaders from area schools. • Public Health has aligned the current CHIP with components of the state plan, addressing the encompassing issu es of adult and youth mental and social well-being. 2026 Goal: Complete a Community Health Assessment (CHA) to identify community health needs and begin development of the Community Health Improvement Plans (CHIP). • Develop a CHA survey and disseminate it throughout the county. o About 503 survey responses have been collected. • Hold community health focus groups and interviews to collect data. • Collect local health data from a variety of sources. 2025-29 Public Health Preparedness: The 15 target capabilities outlined in the CDC's Public Health Preparedness Capabilities: National Standards for State and Local Planning, as well as the Wisconsin Hazard Vulnerability Assessment, provide the foundation for statewide public health emergency planning. Each year, state and local public health agencies evaluate the status of their planning efforts by completing the Capabilities Planning Guide (CPG) assessment. This assessment identifies strengths and potential areas for improvement, allowing Local Public Health Agencies (LPHAs) to prioritize planning, funding, and programming. Each year during the five-year cooperative agreement, Wisconsin identifies capabilities to be addressed statewide. Local planning involves participating in regional exercises, training, developing local sheltering plans, conducting community education, and sharing information. C urrent activities: • Assist with planning and promotion of the regional 211 meeting t o increase awareness of available services a nd strengthen connections to resources in Douglas County. • Plan and present at a region-wide meeting with Public Health, Human Services, and Emergency Management partners to share information on how Douglas County supports mass care operations during emergencies. • Participate in regional emergency preparedness exercises and host local partners, incorporating plans and pr ocedures related to CHEMPACK, public communication, and mass care. • Update Public Health Emergency Preparedness (PHEP) plans to ensure they reflect current procedures, resources, and partnerships. • Update volunteer information to support emergency response and preparedness activities. • Test the WEAVR system to verify functionality and improve readiness for volunteer coordination and em ergency response. • Update communication plans and plans for impacted communities, including strategies for communicating with populations who may experience barriers to receiving emergency information. Communicable Diseases Investigations and Surveillance: Please refer to the attached communicable disease report for year-to-date reportable diseases in Douglas County. D HS Wastewater Monitoring: The Wisconsin Department of Health Services (DHS) monitors respiratory viruses in various ways. One way is to test untreated wastewater regularly for SARS-CoV-2, influenza A, influenza B, and respiratory syncytial virus (RSV), which can indicate whether illness in a community is increasing or decreasing. https://www.dhs.wisconsin.gov/wastewater/index.htm WI Respiratory Virus Data Dashboard: https://www.dhs.wisconsin.gov/disease/respiratory-data.htm *Levels are currently low in our region but are expected to rise as we move to cold and flu season. S taff Outreach, Community Education, and Presentations Staff Topic Organization PH/EH General topics, Vape Escape Room, water quality UWS Youth Leadership PH General topics Health of the Lakes Fair PH Health Education, Immunizations Northern Lights, Northwestern Elementary PH Seasonal health and safety topics Social Media PH Mental Health Awareness Superior High School Ra bies Prevention Rabies is a viral disease affecting the central nervous system. The rabies virus is transmitted from infected mammals to humans (typically via a bite) and is invariably fatal once symptoms appear. There have been more than 500 animals found to have rabies in Wisconsin in the past 20 years, most commonly bats and skunks. Last year, 31 bats were found to have rabies in 22 Wisconsin counties. Few dogs and cats have developed the disease due to the rabies vaccine requirement. Domestic animals that spend time outdoors are at risk of exposure to wild animals infected with the disease, especially if the domestic animal is unvaccinated. Earlier this year, a bat found in Superior tested positive for rabies. No human exposure was reported at that time. The pet that interacted with the bat had been vaccinated. We have had 29 animal bite reports so far in 2026 that required follow-up, including animal quarantine, veterinary health assessments, and medical treatment for the people involved. Environmental Health Laboratory Report Douglas County Environmental Health provides water sampling kits for purchase for bacteriological analysis at the Douglas County Lab. Environmental Health Specialists also collect bacterial samples at licensed facilities and at four city water sites on the Municipal Water System in Superior every quarter. These, along with pool samples, are also analyzed at the Douglas County Lab. *M CL- Maximum contaminant level (10 mg/L) Environmental Health Inspections and Water Samples Water sampling: Douglas County Department of Health and Human Services contract with the Wisconsin DNR's Transient Non-Community (TNC) Drinking Water Program begins January 1 and ends December 31. Facilities in this program serve 25+ people per day for at least 60 days a year using their well water system. Approximately 243 Douglas County facilities meet the TNC program requirements. In cases with positive bacterial results, Level 2 assessments are conducted to identify the source of the water contamination and correct any deficiencies found within the drinking water system. Sampling continues until the facility's drinking water system is safe again, at which time the Level 2 Assessment can be lifted. The owner is provided with education and resources to identify the source of contamination, how to correct the problem, and disinfect the contaminated well system. Health Inspections A national food safety program aims to reduce and prevent foodborne illness. The FDA provides standards for retail food inspection personnel based on food codes. EH staff are required to complete standardization in accordance with state requirements. V iolations: The CDC identifies five top risk factors that can directly cause foodborne illness. These include improper holding temperatures, improper cooking temperatures, cross-contamination, poor employee health and hygiene, and food from unsafe sources. When these violations are evident during an inspection, the Environmental Health Specialist makes every effort to correct them on site. Priority Items include hazards associated with foodborne illness or injury. Core Items usually relate to general sanitation, operational controls, sanitation standard operating procedures (SSOPs), facilities or structures, equipment design, or general maintenance. About 15% of violations last year were corrected during the inspection. If the violation is not corrected on-site, the facility is subject to a billable re-inspection to ensure corrections are made in a timely manner. Over the summer, 41 campground inspections were conducted. The most common violations were related to safety requirements to prevent delays in emergency response. Sub mitted by: Kathy Ronchi, MPH, RN Health Officer September 2026 Douglas County Health and Human Services 2027 Proposed Budget RETURN TO AGENDA Health 2027 Proposed Budget RETURN TO AGENDA Health Budget Summary  2027 Projected Expenditures $915,694  2027 Projected Revenues $372,097  2027 Proposed Levy $543,597  2026 Levy $513,525  2025 Levy $512,168 RETURN TO AGENDA 2025 2026 2025 2026 2027 Actual Actual Budget Budget Budget Change % Change Taxes /Levy (512,168) (513,525) (512,168) (513,525) (543,597) (30,072) 5.86% Grants and Earned Income (193,860) (246,266) (344,924) (351,199) (372,097) (20,898) 5.95% Salary and Benefits 601,122 352,678 571,846 591,732 707,853 116,121 19.62% Contracted Services 74,404 31,091 79,125 79,575 31,775 (47,800) -60.07% Supplies (53,854) 20,370 48,960 44,580 36,255 (8,325) -18.67% Fixed Charges 54,503 31,958 54,984 60,537 56,212 (4,325) -7.14% Grants & Contributions 100,000 - - - - - Capital Outlays 119,266 25,415 5,000 5,000 5,000 - 0.00% Department Allocations 105,775 41,923 91,539 83,300 78,599 (4,701) -5.64% 295,188 (256,355) (5,638) - - - Health 2027 Proposed Budget RETURN TO AGENDA 2027 Health Budget Impacts ARPA grant funding ends 9/30/2026 Decreased mileage expenses due to addition to fleet Level 3 Certification resulting in minor funding increases Fee schedule update and increased # of facilities to license which results in more revenue, but also additional work for current staffing levels RETURN TO AGENDA Human Services 2027 Proposed Budget RETURN TO AGENDA Human Services Budget Summary  2027 Projected Expenditures $15,065,087  2027 Projected Revenues $10,085,564  2027 Proposed Levy $4,979,523  2026 Levy $4,547,527  2025 Levy $4,305,506 RETURN TO AGENDA RETURN TO AGENDA 2027 Human Service Budget Impacts DCF increase of funding for Youth Aids - $82K IDP Courts Fees no longer general revenue –must be deferred until used for allowable expenses ~$30K reduction of revenue Economic Support Error Rate cost to be implemented - unknown how this will be allocated and determined - effective by October 2027 10% increased cost for Mendota/Winnebago placement cost - $176 daily increase Child placement annual rate increases –rates will be published 11/1 Potential addition of EBS position in ADRC unit (mostly state and federally funded) Continuing operating expense price increases in supplies/postage/training/travel/etc. RETURN TO AGENDA RETURN TO AGENDA RETURN TO AGENDA RETURN TO AGENDA RETURN TO AGENDA RETURN TO AGENDA RETURN TO AGENDA RETURN TO AGENDA RETURN TO AGENDA Budgeted Expenses and Revenue by Unit Unit Grants/Income Levy Expenses Administration 657,169 234,581 891,750 ADRC 872,715 24,297 897,012 Birth to Three 121,595 317,992 439,587 CLTS/CCOP 1,370,796 - 1,370,796 Economic Support 1,031,900 412,471 1,444,371 Child Care 84,203 - 84,203 Child Welfare 1,939,862 2,202,059 4,141,921 Youth Aids 1,324,052 153,918 1,477,970 MHAODA 2,614,242 1,427,133 4,041,375 Adult Protection 69,030 207,072 276,102 Total 10,085,564 4,979,523 15,065,087 RETURN TO AGENDA - 500,000 1,000,000 1,500,000 2,000,000 2,500,000 3,000,000 3,500,000 4,000,000 4,500,000 2027 Budgeted Revenue Source by Unit Grant/Income Levy RETURN TO AGENDA 2027 Budget Summary QUESTIONS, COMMENTS, CONCERNS? ANYTHING YOU WOULD LIKE COVERED IN MORE DETAIL? OTHER INFORMATION THAT WOULD BE HELPFUL? RETURN TO AGENDA Douglas County Health and Human Services Current Budget Update Through June 2026 RETURN TO AGENDA Health Financial Results through June RETURN TO AGENDA Human Services Financial Results through June RETURN TO AGENDA Vehicle Reserves Update  Human Services  12/31/2025 reserve = $45,375  2026 addition to reserve = $25,000  Available reserve as of 1/1/2027 =$70,375 + $25,000 2027 budget = $95,375  Health  12/31/2025 reserve = $76,619  Available reserve as of 1/1/2026 =$76,619 + $5,000 2026 budget = $81,619  2026 Vehicle purchase = $25,415  Available reserve as of 1/1/2027 =$56,204 + $5,000 2027 budget = $61,204 RETURN TO AGENDA 2026 Financial Update Summary QUESTIONS, COMMENTS, CONCERNS? ANYTHING YOU WOULD LIKE COVERED IN MORE DETAIL? OTHER INFORMATION THAT WOULD BE HELPFUL? RETURN TO AGENDA Object 2023 2024 2025 2026 2023 2024 2025 2026 2027 Account Actual Actual Actual Actual Budget Budget Budget Budget Budget Change % Change [4100.4199] Taxes - - - - - - - - - - #DIV/0! [4300.4999] REVENUES (29,934) (19,076) (39,988) (16,640) (18,000) (18,000) (18,000) (20,750) (23,400) (2,650) 12.77% [5100.5199] SALARIES 218,156 231,638 225,117 116,669 217,693 230,494 239,140 251,853 239,769 (12,084) -4.80% [5200.5299] CONTRACTUAL SERVICES 5,236 6,424 7,333 2,993 8,550 8,550 8,550 8,000 8,000 - 0.00% [5300.5399] OFFICE SUPPLIES 11,369 21,566 10,879 1,707 17,775 17,775 17,775 13,575 13,000 (575) -4.24% [5500.5599] FIXED CHARGES 912 1,174 1,271 1,242 1,838 1,000 1,240 1,400 1,400 - 0.00% [5700.5799] GRANTS 13,972 12,435 11,190 13,403 6,720 6,720 6,720 8,720 8,500 (220) -2.52% [5800.5899] CAPITAL OUTLAYS - - - - - - - - - - #DIV/0! [5900.5999] DEPARTMENT ALLOCATIONS 2,655 1,943 2,799 1,152 6,020 6,020 6,020 2,300 1,900 (400) -17.39% 222,365 256,103 218,600 120,526 240,596 252,559 261,445 265,098 249,169 (15,929) -6.01% Proof to Detail Tabs - Must be zero - 0 0 (0) - - - - - Proof to JDE - Must be zero - - - - - - - - - @BUCatCode01:020 Veteran Services 2027 Proposed Budget RETURN TO AGENDA 1 2027 Personnel Budget 9/2/2026 Cost Center Dpt Job Description Pay Grade Pay Step Total Contracted Hours Total Contracted Dollars Overtime Dollars 5112 On Call Dollars 5115 Holiday/0.5 Dollars 5134 Clothing/Tool Pay Dollars 5145 Total Extra Pay Dollars Total Gross Wages Total Benefits Total Personnel Cost 47100 020 Veterans Case Manager L 3 2080 64,137 - - - 0 - 64,137 10,186 74,323 47100 020 Asst. Veterans Service Officer K 7 2080 67,079 290 - - 0 290 67,369 11,391 78,760 47100 020 Veterans Service Officer M 6 2080 73,402 - - - 0 - 73,402 13,285 86,687 47100 Total 204,618 290 - - 0 290 204,908 34,862 239,770 020 Total 204,618 290 - - 0 290 204,908 34,862 239,770 https://superiordcwi.sharepoint.com/sites/DouglasCountyFinance/Shared Documents/2027/2027 Budget/1 - Personnel (Updated by 7.31)/Personnel/2027 Personnel Budget RETURN TO AGENDA Douglas County Department of Health and Human Services 1316 N. 14th Street  Superior, WI 54880 Anna M. Carlson Director MISSION To promote the health, safety, and well-being of individuals and families Health Division Suite 324 Phone 715-395-1304 Fax 715-395-1434 Human Services Division Suite 400 Phone 715-395-1304 Fax 715-395-1370 Suite 327 Phone 715-395-1234 Fax 715-395-7371 Memorandum To: Douglas County Health & Human Services Board Fro m: Anna Carlson, MA ; Director, Health & Human Services Dat e: 9/1/26 RE: Request for Opioid Funding I am seeking approval for $150,000, specifically to fund child-welfare placement costs for children impacted by opioids. Fro m January to July, our total for 2026 eligible placement costs to be reimbursed by opioid funding is $139,508. We have already been awarded $75K this year. The remaining expenses for August-December would conservatively be about $17K a month. To fund our current costs and projected costs until the end of 2026, we are requesting $150K, knowing this all could likely be used in 2026. Supporting this use of opioid funds will alleviate the need to use levy dollars for these placement costs. In th e remediation, Exhibit E outlines the approved uses of Opioid Settlement funds. E (10) Provide support for Children’s Services—Fund additional positions and services, including supportive housing and other residential services, relating to children being removed from the home and/or placed in foster care due to custodial opioid use. RETURN TO AGENDA