Mhm. >> Mhm. >> [music] [snorts] [music] >> Good afternoon. I'll call to order this meeting of the Hennepin County Board of Commissioners on Tuesday, May 19th, 2026 at 1:30 p.m. I'm Irene Fernando, Chair of the Board and District 2 Commissioner. I'm joined by District 1 Commissioner Jeff Lunde, District 3 Commissioner Marion Greene, District 4 Commissioner Angela Conley, Vice Chair and District 5 Commissioner Debbie Goettel, District 6 Commissioner Heather Edelson, and District 7 Commissioner Kevin Anderson. Hennepin County acknowledges the magnificent land and vibrant waterways from which our institutions benefit are located upon the cultural, spiritual, and indigenous homeland of the Dakota Oyate. Hennepin County calls attention to the Dakota people's ongoing connection to this special place. On to the agenda, the first item is pledge the pledge of allegiance. Please join me. Pledge allegiance I pledge allegiance to the flag of the United States >> of America and to the republic for which it stands, one nation under God, indivisible, with liberty and justice for all. Next is the approval of the of the agenda. May I have a motion, please? I move. Second. Thank you, Commissioners Edelson and Anderson. All those in favor of the agenda, please say I. I. >> I. Opposed? Motion carries. Three's Hennepin highlights. 3A is EMS Awareness Week, presented by Dr. Timothy Culmer, Medical Director, Hennepin EMS Bridge. Welcome. Hello. Good afternoon. Uh thank you so much for having me. My name is Tim Culmer. I'm an emergency physician at Hennepin, also uh Assistant Medical Director at Hennepin EMS. Uh before the doctor starts talking, I just want to point out that none of the work that I'm going to talk about is possible without the incredible actual first responders, the paramedics, the dispatchers, the EMTs, some of my colleagues who are here in the back. Uh so, all of the work that I'm going to talk about is purely because of the hard work that they do. Specifically, today I'm going to talk about the work that we're doing around the opiate crisis that has uh happened here uh in Hennepin County. So, just to paint a little bit of a picture of what we see at Hennepin EMS around the opiate crisis, we go on about six calls a day where naloxone, medication used to reverse an opiate overdose, is administered. Now, that doesn't mean every one of those calls is an opiate overdose, but it means that something was going on on that call where either another first responder or a community member thought this might be an opiate overdose. Uh but we do think the vast majority of those calls are actual true opioid overdoses. Uh and when we work with our colleagues at the state, what we come to find out is that by volume, unsurprisingly, the vast majority of non-fatal opioid overdoses that involve EMS happen here in Hennepin Hennepin County and Ramsey County. More specifically, Hennepin EMS, we see about a third of all non-fatal opioid overdoses for the entire state. Now, when we first hear that number, it's overwhelming and stressful, and that certainly is for my colleagues on the street. But if we flip that paradigm, we say we have profound opportunity to make an impact on the state numbers here in Minnesota. And when we look at heat maps of where these calls are, we see that yes, the majority of it is centered in Minneapolis, from Lake Street to Franklin to downtown, but you also can notice that it is happening across the entire county. So this isn't unique to just Minneapolis. So, as we reflected on this issue, as numbers were rising from 2020 to 2021, and as the idea of moral injury continued to be popular because of COVID, we kind of had the realization that we were contributing to moral injury with our staff because while we were giving patients naloxone to save their life, we weren't doing anything to get them on the path to recovery, to get them protected going forward. So we talked to a lot of smart people throughout the county and throughout our hospital, specifically folks in the addiction world, and they said, "I don't understand why you don't use buprenorphine," which is a medication for opioid use disorder. Now, what buprenorphine is, it's a pill that you take every day, and it takes away the cravings. If you take it when you're in acute withdrawal, it gets rid of the gets gets rid of the withdrawal symptoms. And they said, "I don't know why you're not using this on the back of your ambulances." And we said, "I don't really know why we're not, either. Let's give it a whirl." So, we did that. We were the first EMS system in the country to have a paramedic-driven protocol. Now, what that means is that the paramedics, just like aspirin or ibuprofen or medications for nausea, can just administer this medication to a patient who fits the criteria. Patients can be in opioid withdrawal either because they got naloxone and they're in acute withdrawal or because they stopped using and they're in withdrawal and they need help. So, we're the first program in the country to allow our paramedics to do that. There's two other programs in the US who were doing it, but it required a physician to be on scene. And we felt that this would be safe enough that our paramedics should practice at the highest level of their skills and they can handle this. So, we did it and we kept a really close eye cuz it was new and it was getting attention. And this is a population that can sometimes not get the greatest care and we want to make sure we're doing them right. So, we tracked it really closely. And after a year, we found that the overwhelming majority of patients got better. Nobody got worse and about a quarter to a third of these patients were still in some sort of treatment at a month, which is really, really profound considering we were at basically 0% and now we've risen. So, it went really well. And we talked a lot about it because we felt it was really important. We felt it was a role for EMS in the opiate crisis. And what that led to was attention. Good attention for once, which is nice and not always the case. And the Department of Health reached out and said, "Boy, we like what you're doing. Where would you like to see this go next?" And we said we would love to bridge these patients, right? This is a hyper-mobile population. It's a population that deals with shame a lot and they're not always willing to step up and say, "Hey, I need help." So, we used money from the state to create the EMS bridge team, which you can see a few of our members there. And what they do is they're paramedics who got extra training and they call every patient from our EMS system or our ED who got in the lock zone or buprenorphine. And they just call them and say, "How are you doing?" Like that's a big deal. You know, if you have a non-fatal overdose, you're more likely to be dead in a year than you are if you have a heart attack. And this is a young population who has a lot of great lives ahead of ahead of them. So, these paramedics call everybody and they just say, "Hey, do you need anything?" And that anything could be I just need some resources to I'm actually in opiate withdrawal right now. I need buprenorphine. And because we have great state laws in this state, they can just drive out, meet the patient, and give them buprenorphine under my license, and it works really well. Now, most patients don't answer the phone. Most patients don't return our text messages. But, what we find is that we get a pretty big uptake about 6 weeks out, where patients will circle back with us and say, "Hey, you reached out after I had that overdose. I actually do need some help." And really, our big goal with the Bridge team is just to let them know that somebody cares. Is to treat them with non-judgment and just to be there for them and kind of walk with them hand-in-hand until we get them plugged into care. And it's been really great. So, with that program, um I just want to pause and say it's not just EMS. I have to give accolades to our emergency department cuz we're riding their coattails. What you see here is the last 10 years, every year, uh the number of doses of buprenorphine given by our emergency department. And it's gone from none uh 5, 6, 7 years ago to about three a day. And I know for a fact that these numbers are higher than other very large health systems in the metro, all of their EDs combined. So, we're really comfortable. And why that is so important is that that has changed the culture in our ED and the culture in EMS around how we handle these patients. And we've slowly gained their trust. We have patients, we have family members reaching out. We've even made Reddit, where people have posted, "I want to get off fentanyl." And people will say, "If you live in Hennepin County, call for Hennepin EMS to come see you. That's how I got connected." And that's a huge win. That might be the biggest win for me out of all of this. If So, we continue to talk about the Bridge program. We talked about buprenorphine on the back of our rigs, which just led to more attention, and it led to EMS systems saying, "Hey, we want to do this, too, but we have no idea how." Right? I'm resource-rich at Hennepin EMS, and a lot of my colleagues, especially in rural Minnesota, are not. So, the state again reached out and said, "Hey, could you kind of knowledge dump into a website?" So, we built this. It's called minbridge.org. And this is kind of a one-stop shop for any medical director, ambulance service provider, paramedic. They can go here, and everything you could possibly need to set up your own program is here. We've also worked with the Minnesota Regional Poison Center. We have a 24/7 urgent call line where they will help providers, paramedics manage patients who are in opiate withdrawal cuz we want to lower the barrier for patients to get on these medications. We continue to work with the state and they wanted to put out formal recommendations on what we can do to lower the barriers for patients to reach these medications and we played a big part in putting out this document that gave formal recommendations to the entire state. EMS and emergency department accessibility is a big part of that. So just wrapping up, what is the future? Obviously, sustainability is a challenge. Putting the medications on our ambulance costs basically nothing. That's just part of what we do. The Bridge team is grant funded. And I know time when we live in very unstable grant funding, that's constantly a challenge. We have 1 year left of that grant funding. We're in the process of applying for other grants and hoping to extend it. We'd like to partner with the jail. We'd like to partner with certain communities, but obviously that can be challenging right now. Um I continue to make a career off of trying to break down silos. We're all doing great work, but we're not always working together and EMS is lucky because we are involved in everything. So we continue to work to collaborate with counties and cities, not necessarily to recreate the wheel, but just work together better. And the last one there is maybe the most exciting. There's long-acting medications of the same type where you get an injection and you're covered for 2 weeks or a month and it's really great and there's a lot of hope there, but unsurprisingly, it's very expensive and it gets caught up in things like prior authorizations and these types of things. So we're working to get grant funding where we could get that on the back of an ambulance. So a patient could go from an unintentional overdose to being protected from dying of an overdose and having withdrawal for a month and EMS does all of that which I really would think would have a profound impact on the community. That's all that I have. Um again, I'm very grateful for this opportunity to talk about the great works that my colleagues do and then have me come up and be the talking head. We'd be happy to answer any questions. Thank you. Very exciting. Colleagues, any comments or questions? Commissioner Green. Thank you, Madam Chair. Thank you so much for the presentation. So interesting and and just really appreciate it. Feels so timely given some other conversations we've been having. I wanted to ask, you mentioned in the research that you're following up a month after and I suspect now you probably have more time under your belt. Like how much time are you able to follow up? It's really hard. It's a It's a really mobile population and the privacy that these patients have to protect them for many good reasons really limits our ability to go beyond 30 days and most of that is actually 30 days within our own partners who are just reporting back to us without patient specific data but they just say, we know this patient sought EMS and just letting you know they're still here. So it's It's actually really challenging to follow these patients any longer, unfortunately. Thank you. Thanks so much and thanks to the team. Commissioner Conley. Certainly, thank you, Madam Chair. Wow, that it was impressive presentation and work I did not know was happening. So that's news to me and nation-leading? That's incredible. I'll just say that you you the paramedics that do this are out saving lives every day. Our first responders are truly heroes and this is just part of that work. I remember that we had been seeing just this gradual increase like not I wouldn't even say gradual, really big increases in opioid overdoses from the ME's office every year and like this year or last year I think we just started to see that number decline. I can bet that the work that you do through this program, through Bridge Team, is part of of what that is and I also appreciated that you mentioned that you may not get to reach them right away but that they call you back in like a month. That that's a connection that builds trust, that helps people get stay sober. And like you're right, these are folks who have their whole lives ahead of us, and you're saving those lives. So, thank you. I know we have EMS staff in the room, so I just want you to stand so you can be recognized, please. COME ON. YEAH. >> [applause] >> THANK YOU, MADAM CHAIR. COMMISSIONER GOTEL. THANK YOU. YOU KNOW, my family's had so many wonderful interactions with EMS on sometimes the worst day of their life. So, and you guys have always been there for them, and they only have accolades to say about you. But, I think learning about this new drug is the first time I've ever heard about it. So, that's great. I'm glad that you're informing us about what we could be doing better, and what we could talk about with our colleagues in in NACO at a nationwide level, because I think this is this is game this seems to be a game changer. So, I'm really excited to hear about what you're doing, and how you're getting this distributed throughout the Twin Cities. So, the only other thing is is I know our our rates are dropping, but it'd be interesting to see those who on this drug what their recurrence rate is. I'm wondering if it's going down significantly. Or, do you have anything anecdotally? I don't know if you've been doing this long enough to have that kind of data, or >> Yeah. So, two thoughts come to mind. Number one, uh rates are going down, which is amazing. One of our worries a little bit is that the Narcan saturation plan for the state worked beautifully. That also means they have to call us less. So, we do wonder sometimes if the rates are [snorts] actually going down, or we're just hearing about them less. So, there's that little question that exists, uh which is hard to figure out. Uh one of the beauties of this medication, and not everybody in this work loves this answer, patients can still use when they're on this medication and be safe. There's a lot of therapy that goes into that experience of using. And patients otherwise can't go through that ritual that has gotten them through so many difficult times in their life, that ritual of using. When on this medication, they can go through that ritual and be safe. And what we find is that even if they do that, they will start to not need to do that ritual as much, which is a lot safer than if they stop taking the medication just to do the ritual. >> Yes, the withdrawals. >> where they could have an overdose or go through withdrawal. So, it helps them get through that initial period of I just have to go through that ritual. I have to go through it. We say that's fine, go ahead. You're still going to be okay. And eventually what we hear is, I don't need to do it anymore cuz my brain is not feeling that high anymore. And it works it's really really great. >> That's amazing. That's so amazing. Thank you for bringing this. Any further, colleagues? I'll also extend my gratitude. Um this is really interesting cuz as you said, 5-6 years ago, naloxone and Narcan were not as commonly um kind of understood. And so, this is a huge point of information and education to more broadly. Uh one question just make sure I understand. >> Yeah. So, this is a medication that must be administered via a healthcare professional, right? Versus No, so they can Okay. Once they get a prescription, they just take it at home themselves. Okay, great. >> Yeah. And actually, one of the things the state just did at this session, which is wonderful, is pharmacists can actually prescribe a bridge dose. So, if you can't get a hold of your provider or whatever it may be, pharmacists will now be able to give a couple days worth of prescription, which is really important again for access. That's That's really great. Yes, I mean, this is obviously a stronger kind of public health response versus the reactive um to an actual overdose. And so, uh again, extend the gratitude for having the intervention, for coming up with how to kind of apply it. Uh I noted that 80% within Hennepin County are from Minneapolis. And so, um I know we're kind of due back to have um a little bit more opioid data. I just wanted to uh acknowledge that for the public, in part because um my I'm interested in disaggregating the the results we've seen county wide to make sure that we are following where there might be disparate pockets that need um you know, uh more specified attention, especially given the multiple public health departments that exist within Anoka County. >> Agreed. Those are just more statements for the public. But yeah, thank you so much uh for your work and presentation. Thank you all so much. Appreciate it. I believe we have to move on to another presentation for a It's the legislative session wrap-up, and so I'll invite Liz Young, director of Intergovernmental Relations, to come up. Chair Fernando and Commissioners, Liz Young, director of Intergovernmental Relations. The legislature adjourned sine die on Sunday at midnight after passing several key bills over the weekend. And yesterday, legislators who are retiring gave their final floor speeches, and we anticipate nearly 25% of lawmakers will retire this year. Before I get to the must-do item of session, I do want to provide a brief high-level update on what else happened at the legislature. Our team would be happy to come back to more fully update you if that would be of interest, and the team is here if anyone has questions on a particular topic. Some of the other high-profile items this year were the state's response to fraud in public systems. This led to the creation of an independent Inspector General General's Office and increased funding for the Medicaid Fraud Investigation Unit in the Attorney General's Office. The state also passed a $1.2 billion bonding bill, which included a few projects that that county will act as fiscal agent for, including the St. David's and Avevo projects. The final legislative compromise on HR 1 mitigates some of the incoming impacts of HR 1, including $10.7 million in one-time SNAP administrative funding for the counties, though no funding to offset the benefit cost shift was passed. Critical access hospitals, which are primarily rural, received a rate increase on reimbursement rates. The legislature also passed one-time funding of $15 million for the Minnesota African-American Family Preservation and Child Welfare Disproportionality Act, and $90 million in modernization of human services IT systems with counties at the table in how those funds will be spent, and specific resources set aside for county specific IT projects. The local homelessness prevention aid sunset has been extended to 2032, and there was also one-time $40 million increase in the Family Homelessness Prevention Assistance Program, also known as FH PAP, to assist those impacted by the staggering increases in rent and Operation Metro Surge. >> [snorts] >> We continued to educate lawmakers on our zero waste efforts, and we're also able to extend the mortgage indeed capture for the Environmental Response Fund, and protect against any changes to the packaging bill passed in 2023. The bill allowing the county to fill a vacancy for the medical examiner's office was also passed this year. There will be no changes to the ballpark sales tax as lawmakers left the statute unchanged this year. The legislature was also unable to advance any funding for small businesses impacted by Operation Metro Surge or gun violence prevention legislation as neither were able to pass the house. Last week, DFL lawmakers held a sit-in for 39 hours as the speaker refused to acknowledge the bill's passage by the Senate and allow a vote as she had promised the parents of students at Annunciation School. Instead, the legislature ended up passing increased funding for school-linked behavioral health grants and anonymous threat reporting for all schools. Overall, the session was challenged by a number of factors, including a future structural deficit and a tied house whose partisan divide has only widened since last year as this is an election year. This year, saving the hospital was at or near the top of every caucus and the governor's to-do lists and quickly emerged as a top legislative issue. What we won this legislative session is funding to stabilize the hospital now and for the next 5 years through a historic financial commitment and partnership with the state to support HCMC. This year, the hospital will receive $205 million through a direct appropriation and payment of their IGT costs. Moving forward, a reserve fund will be available with $500 million backed by the rainy day fund, so there is no general fund impact. Funds will be available until 2031 and they will be administered by the Commissioner of Management and Budget in consultation with the Commissioner of Health and a legislative advisory council. >> [snorts] >> HCMC is the only hospital that is eligible to access the fund and eligibility criteria is tied to static 2024 data. There is a process to request an appropriation, but timelines for responses are spelled out in statute. >> [snorts] >> This funding also comes with reporting requirements to the state and legislature, including a comprehensive financial analysis and quarterly financial disclosure. >> [snorts] >> In addition, there are some changes to governance, including the conditions under which the corporate board can be dissolved and the budget approval process. A new corporate board must be appointed by January. The legislation also establishes a task force for the future governance and financing of HCMC into the future. The task force will begin their work in August and be composed of nine members from a variety of backgrounds and experiences. They will submit a report in January of 2027 and January 2028 with their findings. So, in addition to the financial support, the state is leaning in just as HR1 will begin implementation. Their support and insight into the hospital's finance finances is crucial as the financing of healthcare fundamentally changes. And finally, I made this list of thank you's before I knew the outcome of the legislative session because no matter what happened, it was important to acknowledge how much work went into the legislature this year. So, I'm going to thank them publicly. I'm not going to be able to name everyone, and I'm sure I don't even know everyone who helped us with this, but to name a few. Thank you to you, the board, and especially to Commissioners Conley and Lundy for putting in some serious time and steps in St. Paul this year as our IGR co-chairs. Thank you to Jody Wentland, Kareem Murphy, Jana Johnson, Grace Hanson, Grace Helgerson, Joe Matthews, Lindsey Wolschleger, County Administration, OBF Communications, and to everyone in this organization who dropped everything when I demanded to help us. Thank you to the whole HHS team from Dr. Coming to the countless doctors, nurses, techs, EMS, and labor leaders. You are the heart and soul of why a bill and an ask in a year like this was even possible. The care you provide to anyone who needs it is a model of true public service. And thank you to the patients who shared stories about the worst days of their lives to help us explain why HCMC matters. Thank you to our legislative champions, to the governor and attorney general, and the incredible and dedicated staff at the legislature and in state government. We're grateful for your commitment to the people who make HCMC the hospital it is, and for your leadership and partnership to ensure it remains a critical statewide asset. And finally, thank you to my colleagues in IGR. This session was always going to be impossibly hard after last year, and some days it did not disappoint. But I don't think I had any idea or any of us knew how much would be different and had changed. Thank you, Wanda, Liz, Akolade, Meg, Jessica, and Kirk. And thank you is not enough to Susie and Bre- Brennan. Either one of them could just as easily give this update because they put in just as much time, effort, and commitment to protecting our state's safety net. And with that, we're happy to take questions. Before we open it up, colleagues, gratitude to Director Young and the ENTIRE IGR TEAM. [applause] >> [applause] >> WE ARE VERY, VERY GRATEFUL TO HAVE THE collective expertise and the collective compassion in this team. And Hennepin The Hennepin County Board remains absolutely committed to the vision that we've set, and are grateful for the legislators and to the governor for their wisdom and commitment towards health services that work for people here in Hennepin, but most importantly across the entire state and region. So, with that, I'll first turn to the IGR co-chairs in the event you all wanted to speak, and then we'll see if any other colleague wishes to speak. I'm can't stop smiling. Thank you, Madam Chair. Just it has been a session. And those days at the Capitol, we learned quite a lot. And I will say that your direction, just huddling with Administrator Wentland and the whole team, the dream team, taught me a lot of lessons about strategy, negotiation, how fast things change, how, you know, something that we learned at noon changed at 11:00 when I look at my phone and there's a text message in there. But it's it's it's greatly appreciated. Your work is just immeasurable. The entire team and the and the whole thank you list is my thank you list, right? And I know that uh we're going to come back next year and we're going to do some things. So, you are just um an incredible individual and our team is uh incredible team and uh we >> [laughter] >> when when I get the call I need to show up, I know I better jump in my truck and get on 94. So, thank you. Thank you, Madam Chair. Uh also uh big echoes to everyone. I I do think it was a team effort and I think there were a lot of people who were there a lot and then there were people who I only saw once, but they did something really important by showing up and providing information. I think uh you know, giving credit to the messaging cuz it's so easy to get lost and when you're responding and to lose sight of the fact that we were there to save a hospital. We weren't there to have a conversation about the national politics of health care. We were there for one reason only and I think that uh that very specific focus on that message uh helped us and you know, I also think we were helped by the fact that HCMC has been saving lives for a long time and there are a lot of people who are connected to the hospital. So, I thought, you know, the hard part was going to be committing getting people to commit to this place can't close and that was the easiest thing. That was done for us because of the good work that the hospital had done. I think that even the people who didn't at the end of the day vote for our bills or didn't really support us, they all wanted to see the hospital saved. It was just the method of how we go about saving it. So, um I felt heartened by that and just the the conversations across the board. Um, and we're not done and uh because this still is a problem statewide with how health care is set up where it's it's really rationed and people who can't afford to pay for it are the ones being driven out of the system and uh I think there's opportunities for us as a county and as a hospital to lead in that conversation because it's not just us. There's I think 21 or 22 hospitals around the state that will close this year or next year unless something happens. And the truth is is that a closure of a hospital in a rural area hurts worse than a closure of a hospital in a metro area because we have hospitals. But when you are 3 hours from your hospital and that closes, you're now 4 to 5 hours away. And we would never stomach the idea that people would be 4 to 5 hours from getting to the hospital. So I think there's a lot of work and I know legislators feel that there's a lot of stuff left to be done, but we are still alive, we're still fighting, and and I think that really speaks to the effort of everyone involved and the importance that everyone believed in that. [clears throat] And maybe this will spark people to take a second guess when they just accept the hospital closing somewhere and go, "Oh well, you know, there'll be another place for people to go." And I think that's bad. The last thing I'll just say check to make sure what I say is true. Last night was the first night I haven't texted Liz in weeks. And I did check it. There was one at in the mid-afternoon, there was one this morning, but nothing last night. And so I just want to point that out as a very big step. Congratulations on your evenings back. So thank you. >> [gasps] >> Go ahead, Commissioner Colmey. Uh Manager, I just want to add one more thing. In addition to the thank yous, just some some things that I have not seen before ever. People were holding vigils outside of the hospital. There were hundreds of people showing up to rallies. Every person I ran into in the street, at community meetings were just, "Thank you. Please save our hospital." Every person I talked to has a has a HCMC story. I do. We all do. And I think that tells a such a rich story. Every time I show up to testify, staff from that hospital were showing up to testify. So, all of the staff that work there day in and day out are also incredible human beings. And the way that the community, the way that the Hennepin County community wrapped around this hospital was really a sight to see. And that just it was love. It was all just rooted in a love of a place that has saved lives, that has healed the sick, that had done so with the utmost care and urgency. So, thanks to them as well. Commissioner Green. Um, thank you, Madam Chair. Thank you, Ms. Young. And thank you to everybody who you named as well. I want to join that. I really was struck that between the our IGR team, commissioners, administration, the story placement in the Star Tribune, you know, etc., etc. It was like an orchestra. And anytime you felt like, "Ooh, you know, we could use some trumpets right now." or something. Oh, there they'd be coming right in. It was really fantastic. Um, I wanted to also thank AMC for providing a space to build allyship across the state. It really interested me that I was, when I was at the legislature, and it was funny, I was opening every meeting with like, "I'm not actually here to talk about the hospital. I'm here to just update you on the Blue Line." Um, and people wanted to hear those updates. I'm glad. But, the there were so many questions about HCMC and the buzz in the hallways was around about HCMC. That felt really powerful. And that was actually relatively early on. And it just felt like it was sort of nurtured and nurtured and nurtured. And the the sort I always think of like the heat index on topics. And the heat index was just like at such a great dial, you know, the whole time. It was it was it was um magnificent, honestly. Um, I also want to thank our residents. Thank you, Commissioner Conley, for describing how it was in your district and I would say my district, too. Like literally everywhere I went, everybody was like 100% wanted to sort of hear from me that of course I was on board, hear from me that absolutely the seven commissioners were working together, um, that you know, we were this was a a sort of full court press and that uh, there was nobody who was not, um, channeling energy towards making this a success and I thank them for, you know, every time I spoke with people I would say like, well, be sure to let your legislators know, you know, I can tell you they're, you know, because I would know what our legislators were thinking, but let them know anyway that you're grateful. And I just want to thank them for that urgency and something that always strikes me, um, in elected office, like I think one of the greatest honors that we have as elected officials is that people tell us their story and tell us like what is most personal to them and their dreams and aspirations for the region, yes, but also like what's going on in their lives and the ways in which we can support them better. And that came up again and again in the conversation around the hospital with people sharing stories of how it had touched their lives and the lives of those that they love. And it was it was amazing. Um, yeah. Uh, I also wanted to offer I appreciated it was said next year we're going to do some things and I I'm I'm up for that, raising my hand already, and I'm here for sort of this level of coordination and alignment and strategy on this and anything in the future. Thank you so much. Commissioner Gotel. Thank you. I'm I'm going to try not to repeat too much with my colleagues, but I want to talk about what I saw out there, too. Um, while I I talked to legislators, I talked to my colleagues in the county, I heard from employees. There's a lot of employees in my cities where I'm at and everything and just people I know who are employed by HCMC and and they didn't want to leave. These people didn't want to leave. I know we've lost a few people. But they said, "No, we want to be here. This is what we believe in and yes, we could go someplace and make more money. That's not what it's They say they want to retire from HCMC." That that speaks volumes, you know, and for us to give them that stability right now means everything to them because this is their lifelong love and now they get to pursue it. So I just have nothing but gratitude for, you know, this wasn't what we first asked for, but it's probably what we needed and it's probably what we can get through and it's probably what we'll we'll make work for us, right? So I'm going to I'm very positive about this. And you know, I want to thank our chamber businesses, the other hospitals and clinics, too. They came up and said, "You know, we can't take on if if HCMC closes, we can't take this even if some of their departments aren't here." And I think our rural hospitals and clinics are great because they see, if we can do this here, you know, we have a chance next year maybe to get some more for us so that at least the legislature, I think they have it in the back of their minds always that they have to do something about HR1, the changes and what it's going to mean for our rural hospitals as well as our urban hospitals. And so I just want to say how grateful I am to everybody here, unions, employers, staff at HCMC, our my county board colleagues here are just great. I just have a lot of gratitude. Thank you. Commissioner Anderson. Thank you, Madam Chair. Um and thank you, Liz and team for the incredible amount of work. I I just want to share um some experiences that I had because the thanks have already been said very adequately. Uh but Commissioner Green, you mentioned the stories and I you know, was had been approached by so many people uh who said, "My loved one works at HCMC. What are we doing to to make sure that uh the hospital is going to be around?" Um or my brother had an emergency and was taken to HCMC and they saved his life. Um and those stories were repeated uh in circles, you know, community spaces, in public, at the capital, uh in like organizations. You mentioned AMC. I I think every commissioner that I talked to across the state has an HCMC story. Um and I I think that is speaks volumes to our ability to connect with people, the work that you were doing of making sure that uh the audience was receptive to what we were saying. Um and I do want to say one specific thing. Uh I was at the capital and uh a few people approached me and said, "Please make sure that you thank your IGR team and acknowledge them for how well they worked on this because they said, 'Every conversation with every single person uh at the capital was how are we saving the hospital?'" And they all saw the value in it. They saw it as excellently executed uh and essential to how we preserved our our health care system. And yes, there's still a lot of work to be done. You know, this was uh one time, um kind of a set period of time, and we do need to find a permanent solution, but because of this work, I think we are positioned to be able to do that, um, and I can't thank you enough for giving us the opportunity to do that. So, thank you. Commissioner Elison. Well, I I felt unlike last session, I'm grateful, too. So, I just want >> [laughter] >> I I just want to say that I'm I'm absolutely grateful, and I think honestly, it's a huge accomplishment in a divided legislature to get this. And so, bravo to our communications team, to each of you and IGR for what you did here, um, that it was bipartisan, that it kept on message, and that that it we got it done. So, congratulations on that. Um, on the task force that's coming, because there is multiple different things that we'll be following. Um, I just think that that's something we're going to really want to make sure that we're following, uh, and so, I don't know if IGR is going to be helping us with that, or if we'll have county staff doing that, but, um, just making sure that, I mean, given that it is it is currently our asset, we need to make sure that we're we're monitoring the task force. Um, but yeah, congratulations, and I mean, I was helpful to hear, too, Zach Stevenson say that next year was going to be about a lot of conversations about hospitals. And so, I think that sets the tone for next year, as well, as just making sure that when people think about what government is in a society, you're playing like with Barbies, and you're like, "What's government?" I don't Maybe that was just me. Um, it you're thinking about roads and bridges, you're thinking about making sure you have public safety, and you're making sure you have health care for people. And so, I think ultimately, um, it's good that that, uh, this session really highlighted that. So, thank you. And just, uh, since you had mentioned it out loud, Commissioner Elison, for those watching at home, there is a governor-appointed governance task force that, uh, was a part of this, um, that I think is meant to be up and running by August. And then, Hennepin County has a governance kind of effort with a report due in June. So, uh governance is going to mean a lot of things as it relates to our hospital and health systems moving forward. >> [gasps] >> And so, just that in uh in closing, we have an amazing gratitude for each of you, incredible partnership across the state. I do want to uplift the modernization effort from that we were a part of with AMZ AMC. Really to shout out Hennepin workers. I mean, Hennepin workers have done a lot of heavy lifting in advance of the modernization work enabled in order to kind of identify the interventions that would be most practical on behalf of counties. Um lots of advancement for shelter MAT plus services. And so, I just want to acknowledge that there was um in a divided legislature where partisanship is not, you know, always easy, our Minnesotan legislators came together to prioritize families and people and caregiving. And we extend absolute gratitude to the makers and the governor um for their support in that. Uh my last comment is I've been reflecting on this cuz everybody has a story about HCMC. And the story of HCMC, how it's being spoken about, is wonderful cuz we have this incredible service that's statewide. Um but as a couple of colleagues have mentioned, the story of HCMC is also a story where our rural neighbors are not receiving the care or access that they deserve. And so, I certainly look forward to um partnering across the state uh in advance of the revenue replacement needed for HR1 to really develop models where, no matter where you live, you can get to a labor and delivery center. No matter where you live, you are able to access the routine preventative care. Um no matter if you're here for an emergency and you happen to be enjoying the beautiful nature in northern Minnesota that you're able to access um the health services that uh that yeah needed. So, I I hope the public uh certainly hears an incredible alignment um from their elected officials across the state around how services are absolutely on our minds and we look forward to advancing uh a service ecosystem a health ecosystem that uh works now and in the future. So, with that clearly no questions for you, just a lot of us chit-chatting up here, but thank you um and one more round of applause for this up. Okay, next up we have um minutes from the previous meeting 5A is April 28, 2026. Actually, I'm calling an audible. Can we take a picture with you all? Yeah. Oh, no, no, [laughter] no. Okay. All right. All right, you guys. So, you didn't escape. I'm so sorry. >> Yes. Okay, now we're on to 5A, April 28, 2026 meeting minutes. May I have a motion, please? >> So moved, Gotel. Thank you, Commissioners Gotel and Anderson. Any notes or corrections? All those in favor, please say I. I. Opposed? Motion carries. Six is referral of correspondence and department communications. 6A through D are correspondence and 6E through Z are department communications. May I have a motion to accept and refer as recommended? So moved. Second. Thank you, Commissioners Landy and Connelly. All those in favor, please say I. I. Opposed? Motion carries. Seven is commendations, for which we have none. Eight is commissioner communications, and we have several. First up is National Police Week and Law Enforcement Memorial, offered by Commissioner Landy. Go ahead, Commissioner. Thank you, Madam Chair. In 1962, President Kennedy proclaimed May 15th as National Peace Officers Memorial Day, and the calendar week in which May 15th falls as National Police Week. This year, National Police Week was observed Sunday, May 10th, through Saturday, May 16th. Every year Hennepin County Sheriff's Office and the Minneapolis Police Department co-hosted an event to honor peace officers who have fallen in the line of duty within Hennepin County. This year's memorial event was held at Tuesday, May 12th, outside Minneapolis City Hall. The names of all 67 fallen officers, going back to the year 1884, were read out loud. Not all professions require you run toward danger, but the men and women in law enforcement do that every day. Last week's memorial event was a time for us to reflect on those who have given the ultimate sacrifice. It was also an opportunity to express our deep gratitude, not only to officers, but to their families and the sacrifices they make. I know many of my colleagues were able to attend and represent this body, demonstrating our support and partnership with local law enforcement agencies. These brave individuals selfishly gave their lives in the line of duty during National Police Week and the law enforcement and at the law enforcement memorial, where honor all who take the oath to serve, remember those who made the ultimate sacrifice. Thank you. Thank you, Commissioner. The next communication is Doors Open Minneapolis, offered by Commissioner Greene. Thank you. Let me go to the right, please. This year, on Saturday and Sunday, May 9th and 10th, the Hennepin County Government Center participated in something called Doors Open Minneapolis. Doors Open is a is an annual event that offers a chance for the public to explore behind-the-scenes look at buildings and spaces around the city. This year, more than 75 venues participated in the event. Here at the Government Center, we had 720 guests visiting across both days of the event. Visitors got to learn more about the building, its architect and history, and take tours of the Government Center spaces, including this very room, the County Board Room, District Court Self-Help Center, the Jury Assembly Room, the Court Room, the Law Library, and to enjoy the fantastic views from the 24th floor. I want to thank residents and visitors that came out to explore the Government Center, and a big thank you to all our staff that gave tours and made this event a success. I know it's a favorite out there in the community, and people are always sort of comparing notes about where they went and what they saw. So, it's a wonderful relationship builder. Thanks. Thank you. Uh next is the State of the County recap offered by myself. Just this past week on Thursday, May 14th, we held the 2026 State of the County address, where I had the opportunity to speak about successes that Hennepin County's had in this past year, um as well as our vision for the future. The State of Hennepin County is strong because of the people of Hennepin County, the compassionate caregiving from our workforce, and our collective resolve for a more just and um vibrant future. The event was held in the 625 building auditorium in downtown Minneapolis, and was also live streamed for those who could not attend in person. I want to take a moment to thank our featured speakers and performers. Um Elder LeMoine LaPointe led a ceremonial blessing to start our event, and known MPLS choir gave two incredible performances to open and close the address. We had a fantastic turnout, and were joined by community members, county partners, and leaders from local governments and businesses. Thank you to everyone who attended, and last but certainly not least, I want to thank all of the staff who made this event possible, um from production to the generating of the speech and highlighting uh key accomplishments for our organization. For anyone who was unable to join us for the day, or if you want to, you know, have a nice 90-minute uh background music of my voice, uh feel welcome to check out our YouTube channel, where we have the full address, um and we are certainly always um accepting feedback and want to make sure that this is an event that represents Hennepin County uh residents and workers. That's what I have, and the last update is Global Accessibility Awareness Day offered by Commissioner Gottschalk. Go ahead, Commissioner. Thank you, Madam Chair. This Thursday, May 21st, is Global Accessibility Awareness Day. The purpose of this day is to get everyone talking, thinking, and learning about digital access and inclusion for more than 1 billion people who live with disabilities. Hennepin County understands the importance of digital accessibility to create and maintain inclusive experience with websites, digital tools, and technologies for both employees and for the public. We are committed to provide digital information that is accessible to everyone regardless of their um ability. To elevate, prioritize, and need for accessibility, digital experience, and services in this county, we adopted a digital accessibility policy. That was back in 2022. We created our digital accessibility roadmap that outlines critical steps to help the organization build long-term digital accessibility maturity and made available testing tools, training standards, best practices and guides, including the county's design system to support employees as they created and managed and improved these digital contents for online experiences. I encourage everyone to take the opportunity to learn more about digital accessibility. Accessibility grows when more of us understand the challenges people face, and when we learn, practice, and build with inclusion in mind, when we learn, practice, and build with inclusion in mind for this week and all years along, the county calls on all of us to recognize the importance of accessibility, digital services, and the role we all have connecting with residents for information, for resources, and for opportunities for those folks. By learning from the experiences of people with disabilities and removing barriers wherever we can find them, we strengthen our community and ensure that every resident can fully participate in county programs and services. Accessibility is not a one-day effort. It's an ongoing commitment to serving everyone with dignity, equity, and inclusion. Thank you, Madam Chair. Thank you. Moving forward on the agenda, we are at the claims register. 9A's for the period ending May 1, 2026, 9B for the period ending May 8, 2026, and 9C is the claim register for the period ending May 15, 2026. I move the acceptance of all three. Thank you, Commissioner Green. Second. Thank you, Commissioner Anderson. All those in favor of uh 9A through C, please say I. I. Opposed? Motion carries. Uh 10R consent items. These are items that would have passed unanimously out of committee. Um I'd like to pull out 10I, so I will move 10A through H and 10J through 10O. May I have a second? Second. Thank you, Commissioner Goddard. Uh before we vote on that motion, uh a lot is uh in this any any items that colleagues would like to highlight? Any And seeing none, all those in favor, please say I. I. Opposed? Motion carries. Um we're at 10I, the amendment to an agreement with Wellness That Fits LLC to provide mental health and wellness services to Hennepin County Sheriff's Office employees the period June 1, 2024 to May 31, 2028 increasing the not to exceed by 450,000 for a new total not to exceed of just under 907,000. I'll move this. May I have a second? Second. Thank you, Commissioner Landy. Uh colleagues, this is a consent item. I support the item, but I just wanted to publicly acknowledge that I had asked for follow-up information for which we did receive and wanted to clarify I'm in receipt of a confirmation that I read this accurately that any unspent funds allocated towards this cannot be reallocated to a different use. So that would be the question that I have for you Ms. Watland or for someone to confirm and then we can move to vote unless there's more discussion. Chair Fernando, Commissioners, Rick Bezosky's here and can respond to that question. Thank you. Welcome. Uh good afternoon, Chair Fernando and Commissioners. My name is Rick Bezosky. I'm the finance director for Hennepin County Sheriff's Office. And last week you heard from Chief Enderline and Major Bocky and they went through the details of this agreement and I understand you'd received some additional follow-up. And in developing the not to exceed for this agreement, HCSO accounted for consolidating the agreements for Community Growth Solutions and Wellness That Fits agreement. And in addition, we want to ensure that we had enough room in the agreement to account for any fluctuations in spend due to unforeseen critical incidents that required a greater need for wellness resources. This is not a request for supplemental budget appropriations and any unspent dollars would not be going to another agreement. Excellent. Thank you. Colleagues, any further discussion? Hearing and seeing none, all those in favor of 10 I, please say I. I. Opposed? Motion carries. 11 is non-consent. These are items that would have passed out of committee but not unanimously for which we have none. 12 are progress items, meaning that you would have progressed from committee to board without a vote and we have two. 12A to authorize supplemental appropriations and contingency transfers to amend the 2025 budget. May have a motion, please? >> So moved. Second. Thank you, Commissioners Goettel and Landy. Ms. Landy. Chair Fernando, Commissioners, Joe Matthews, our chief financial officer here and can provide background information. Welcome. Thank you, Madam Chair. Joe Matthews, chief financial officer here in Hennepin County. And this is part of our annual process to close the prior year's financials. There are 13 adjustments that we're making here in this resolution and I'll just briefly mention each one. There's also a schedule in your packet that has the accounting information as far as what's taking place. The first adjustment is for Hennepin Health. They've had higher enrollment than budgeted. It's a non-property tax-funded department here at the county and so they have revenue from their operations to pay for their increased costs. The next two items, two and three in schedule one, are for Department of Revenue fees for administering our sales taxes and so this is just a recognition that our fee structure changed since we adopted the 2025 budget, so it's just reconciling that. The items four and five and six are all related to internal service funds here at the county. We have fleet services, our other employee benefits department, and the employee health plan. Those are all funds that are self-contained and have revenues that are generated to fund those operations. There's also a memo that you were provided yesterday that has some additional background if you're curious about those or I'm happy to answer questions. And then we have three contingency transfers. I do want to identify that on page 131 of your packet, the numbering on the second page of the schedule got a little uh skewed, but uh these are items seven, eight, and nine for adult representation services, for the compliance department, and for operations administration. For ARS, uh we had some changes to that department mid-year, and so their budget uh was not adequate to fully cover the increased operations. We added five attorneys in order to meet demand in that department. The compliance department uh is also a very small department that was new last year, and as we went through the year we recognized that we did not have adequate resources uh dedicated to that, and that's been corrected for 2026. The operations and administration department, um that is where a number of costs for the improvements to the 625 auditorium take place. Their business information officer has helped coordinate the technology upgrades in that space, and so this is also recognizing that those costs um occurred in that space. The other budget adjustments that are before you, they're technical adjustments to public works services and housing and economic development. Um this is related to changes in uh um accounting practices. They don't impact the uh general funds balance. >> [snorts] >> And then the last two um are two adjustments to capital projects with no net effect on the CIP. There is a adjustment for the Hennepin County Government Center courtroom jury reconfiguration project, which is complete, uh and this actually decreases the budget authority uh in that project uh to make it available for IT connectivity and transfers it to that project. And then the IT connectivity project is the other end of that transaction, and they've had increased costs for fiber installation, and so this is a way to rectify that without adjusting the overall budget, and I'm happy to answer any questions you may have on those. Thank you for the overview and for the memo. This is an annual reconciliation that we do. Colleagues, any questions or comments? Hearing and seeing none, all those in favor of 12A, please say I. I. Opposed? Motion carries. 12B is to establish annual Heart of Hennepin Service Awards offered by Commissioner Elsmore, and I want to draw attention to an R1 that has been sent out. Would you like to move it? I I'll move it. I'll second it. Go ahead, Commissioner. Uh thank you. This was just taking feedback. Thank you to my colleagues that that gave some feedback last week. And so the R1 just incorporates that there will there intent is that there would be multiple awards. And then just clarifying that it would be neighborhood organizations, which I think was a really good change actually because I think us getting into awarding organizations could be problematic. So thank you for acknowledging that, and and and that is all it does. Thank you so much for bringing it forward, Commissioner. Colleagues, any discussion on this item? Again, thank you. Recognition and ensuring that there are ways by which our community can really feel kind of interactive in terms of our mission is wonderful, and so thank you for bringing this forward. All those in favor of 12B, please say I. I. Opposed? Motion carries, and the R1 is approved. 13 is old business. These are items that would have been seen by this board previously and laid over to today, for which we have none. 14 are immediate approvals, and we have one. 14A is recognized incredibly grateful for this work here in Hennepin County. The proclamation is recognition for invaluable work that the Hennepin County Community Action Partnership, often called HCAP, and all community action agencies have done across the country. I'll have the clerk read the recommend the commendation and I'll have some additional remarks at the end. Thank you. Whereas community action creates pathways to prosperity by helping hardworking families achieve economic independence rather than keeping them reliant on government assistance. And whereas community action is built on innovative, responsive, and efficient programs that are uniquely tailored to meet local needs. And whereas community action delivers high-impact, cost-effective results that generate a significant return on investment for local communities. And whereas community action prepares and connects individuals to private sector jobs to support the local economy. And whereas community action agencies are trusted pillars of the community that engage volunteers who donate their time to advance local progress, support working families, and contribute to lasting community success. And whereas community action programs deliver effective, high-quality assistance that strengthens community resilience and fosters local prosperity. And whereas 2026 marks the 40th anniversary anniversary of Community Action Partnership of Hennepin County's founding in 1986. Be it resolved that the Hennepin County Board of Commissioners proclaims May 2026 as Community Action Month in Hennepin County. Um thank you so much um Ms. Rose for reading that and I want to correct myself. I I think I had the ambulance service on my mind so I said HCAP but it's actually CAP-HC, Community [laughter] Action of Hennepin County. Uh and I wanted to mention that uh the probably the reason I'm bringing this forward is that I replied first to an email but I'm joined by Commissioner Gatell and Commissioner Edelson in service on the board of CAP-HC and I think there've been three county commissioners serving on the board of CAP-HC for a number of years um perhaps even since its founding actually. It'd be interesting to find out. Uh and that really speaks to the long-standing relationship and alignment of missions. Uh so um the other thing that we should be acknowledging is the 40-year anniversary of um CAP-HC here in Hennepin County. I know some of you will remember that we also celebrated the anniversary of community action partnerships across the United States. Um but it's fun to connect here with the uh long history of CAP-HC here in Hennepin County. Um are there other remarks on Sorry, Madam Chair, please. >> please. Go ahead, Commissioner Elson. Sorry, I just wanted to um also acknowledge uh Dr. Hightower is here who is the executive director and um just such an incredible leader of CAP-HC. And so, thank you for coming uh downtown. And it's been really an honor to serve on um on CAP-HC. Just to learn, quite frankly, before I came here, I had no idea what CAP-HC did. Um but now I realize just how important your role is. And it's it's kind of like the county where we do a lot of hidden things. Um CAP-HC does a lot of really important things to uplift families. Uh and so, uh Dr. Hightower, I just want to thank you genuinely for all the good things you do. So, thank you. Commissioner Gotel. I I do And thank you again, Dr. Hightower, for making time out of your busy schedule. It's been a challenging few years, and it's not going to get easier. So, thank you for for just taking this challenge on, staying the course, and making sure that we can help the people that we really care about. Um I've been on the board of CAP-HC actually 22 years, some odd years, off and on. Um because they also have cities. So, I served as from the city perspective as well. So, I've been through a lot of different executive directors, too. And it's still survived while a lot of other CAP organizations did not. And in fact, we have absorbed other organizations because of the hard work that we have done and because of our relationship with the state. And not all CAPs CAPHCs have that great relationship with the state. But that's also to the leadership of the organization. So, thank you for your hard work. Commissioner Green. Um thank you. I also wanted to thank um Dr. Clarence Hightower for being here and for your leadership at at CAPHC. And I something that I've especially appreciated recently, um although I'm it's part of you, is your creative thinking and the way that you're always thinking of ways to advance the mission of the organization. So, many thanks for that. Further discussion. Yeah. Hearing and seeing none, let's vote on the resolution. All those in favor, please say I. I. >> I. Opposed. Motion carries and May is officially Community Action Month in Hennepin County. And uh Dr. Hightower, I don't know if you wanted to share any words, you're welcome to, but we definitely want to take a picture and have a proclamation for you. So, uh it's up to you. Take a picture. Yeah, makes sense. >> And that concludes our public agenda. Motion to adjourn is in order. Second. Thank you, Commissioners. I'll also need a gavel. All those in favor, please say I. I. Opposed? Motion carries. We are adjourned, but don't go too far. We have a brief meeting of the Rail Authority coming up next. Good afternoon, everybody. Today is Tuesday, May 19th, 2026, and I'm going to call to order this meeting of the Hennepin County Regional Railroad Authority. Uh our first item of business is to approve the agenda. So moved. Um motion from Commissioner Anderson and a second from Commissioner Fernando. All those in favor say I. I. All those opposed, our agenda is approved. Um, excuse [clears throat] me, our next action is to approve the minutes from the April 28th, 2026 meeting. That's item 2A on our agenda. I'll move approval. Second from Commissioner Gotell. Any notes or edits? Seeing none, all those in favor say I. I. All those opposed, the minutes are approved. Um, we have no claims registers today. Under new business, item 4A, we have to negotiate an agreement with the Minnehaha Creek Watershed District for programmatic maintenance responsibilities with no cost to the Hennepin County Regional Railroad Authority. Uh, and a map has been attached. Uh, again, I'll move approval. Is there a second? Second. A second from Commissioner Anderson. Any What Anybody need to see more questions? Seeing none, all those in favor say I. I. All those opposed, that item passes and we are adjourned. Thank you.