[Music] Scott County providing safe healthy and livable communities on to Scott County delivers um we're talking today about aging and disability services so Chris Harter you're going to get us started I bet the that the county provides to our most vulnerable residents and a few things I just want to say to start us out we are going to talk about our aging population and we are going to talk about our population of people who live with disabilities and those are two uniquely different populations and we have some discussion and some data for each of those populations but they are served by a very overlapping common service array and so um many of the services the county provides serve both of these populations so we'll hope to be clear in our questions if we're talking about aging residents or disabled residents but we certainly um certainly welcome your questions around that in terms of the information on Aging residents much of the services to our aging residents happens through Community Partnerships or Insurance programs and so um I think a lot of the information you're in here today about the Aging population will be new the data at least will be new in terms of the information on um Disability Services um that is data that you've seen before and discussions we've had before for today I think it tees up some future conversations that this board will have with our HHS Partners around men choices and around some strategic planning around disabilities and uh services to aging r ents so today is kind of a a kickoff for that we certainly welcome any questions want to hear what you'd like to know more about as we move into workshops in a few weeks um so with that um I'm going to ask the facilitators to introduce themselves um then we'll ask each of you to introduce yourself and who you just who you represent what organization you're with and then we'll get started good morning my name is Scot and I'm the director of Emergency Management and 911 Communications good morning I'm Lori hus I am the employee relations director good morning Jake grusing transformation Enterprise Services director good morning I'm shaa biskin and I'm with the men choices assessment team good morning I'm Peter Goldstein I work as our health and human services housing supervisor WIS Scott County good morning I'm Terry Hassen and I represent the Scott Carver Dakota cap agency good morning I'm Terry steer chief of police city of bplan hi I'm Paula lerer I'm the adult services coordinator at the scottt County Library good morning Britney Lane manager of Aging and Disability Services Sarah mson volunteer and Community coordinator PTY Freeman the general manager for scat County clle and Alan Alan her transportation services Mobility management thank you thank you everyone all right I think I'll start um the questions off um jumping off of what Chris had done an introduction to ask you to elaborate a little bit more about all of these different programs there's so much in this packet and so much important work how do you all interact intertwine kind of come together with your services where do you touch and and how do you serve together the the people that we are um talking about today that's a great question and I think part of what we're learning and even bringing this information forward is that we each do touch um serving people are aging or people with disabilities we each have a role to play and so bringing this information forward we're figuring out what are those intersections I don't I'm not sure that we've fully explored all of that uh but that is part of what's written in our next steps exploring that further so that we are making a um intentional and strategic plan moving forward for how do we work together best because aging and disability populations in Scott County that's a really Broad and wide topic and it it will take all of us to do a good job i' like to take us to page 21 so in this slide we're looking at the client ratings of County and contracted uh Case Management Services um so two questions first of all the easy question do we know hopefully it's the easy question do we know what the reason is for the reduction in responses we're receiving to the survey and then a follow-up question to that is looking at the four different organizations uh that are working through these assessments what are the measures that are used to actually assess the contractors doing this work so how do we know uh that they're being effective in in the work they're doing so slide 21 this is specifically about case waiver Case Management Services so this is separate from in choices um in choices that team does the assessment it moves on to a waiver case manager um currently in 2023 you can see um there were five contracted case management agencies we were using along with Scott County staff and so your first question was about why the reduction in responses I'm not sure um what this where we're gathering this information from this is an annual survey that we send out to all the people that have received Case Management Services and they're asked to rate their level of satisfaction on a variety of topics um in 2023 we did switch a little bit we we adjusted how we were um administering the survey the types of questions we were asking um and it was sent out more electronically than we had in the past historically we've done a um a mix of snail mail and sending out by email um I believe we did more of an electronic push this year that might be why we saw a slight reduction but I'm that's just a guess your second question was about um contracted case management and how are we um what are the measures that are used and how do we know if contractors are effective in what they're doing and delivering what we expect them to yeah there's a there's a few different um ways that we're doing that what what you're the data you're looking at in front of you this is just by um the people receiving that service how do they feel about it um two of the contracted case management agencies they were new in 2023 so I I I suspect some of the what we're seeing in the in the data is them getting used to this how we administer things in scat County um but we do have support staff here at scat County that um uh we we do routine audits to make sure that they are meeting all the compliance measures that we have to live up to um there is also a lead agency review um DHS does that every few years where they're they're looking at all of our work um in the work done by contracted case management is a part of that um so there's a few different ways that we uh have some oversight of the work they're doing thank you what what's the reaction to that the the data on the far right on that slide that there's a there's a real shift from the previous survey results for both mostly for the contract case management what what's the reaction and maybe next step based on that information sure um I my my initial reaction was I actually feel quite pleased that um the majority of respondents are saying the service is average or above um there are certainly are a few that stated it was below average or poor but um I actually thought it would be higher so this I'm pleased with um the other reaction is in 2022 it says there were two organizations under the contracted case management measure but I know that we only received responses from one agency so um 2022 really it's responses from one compared to 2023 we we got responses from all four two of which were brand new so that to me says um we may take a more we will take a more targeted approach in the support and the um training that we're providing to them because it matters it matters because Scott County is rated on this whether our internal staff are providing the service or a contracted vendors so it would be wise of us to make sure they have all the support that they need to do a good job serving the people that live here I'd like to go to page 15 please and my question is um what are some of the greatest challenges for those trying to live at home did I go to the wrong page as I see good well I would say that the house that they bought when they were young and working and capable sometimes no longer suits them so they have steps they have things that they didn't Envision that would happen to them I mean we all know that we're going to be aging but when it really happens to you we no one can predict usually with certainty what health challenges you're going to either inherit develop um by accident or through you know your job also the income that is needed to sustain today's lifestyle has been greatly compromised I work um with uh primarily seniors now but I used to do snap Outreach so a lot of people it's very sad when you get a call from somebody who's 96 who has to apply for food stamps for the first time in her life she never thought she'd outlive all of her savings her income from Social Security which half of all seniors are just living on Social Security which of course is dependent on your either lifetime of work earnings or your spouse's earnings medicare premiums have gone up of course you know cost of living the um housing rents have really people can sometimes control their U mortgage payments or hopefully they don't have a mortgage anymore but you can control the insurance which has skyrocketed for their homes and then the taxes they have no control over that um so I see that with a lot of the seniors that I help they're asking for help with home modifications they're asking for help with you know cleaning yard work all that type thing but then I refer them sometimes they want to sometimes they don't want to apply for other services such as the food stamps um used to be a Medicare counselor Medicare Savings programs you know all that type of thing so I try to energy assistance I try to get them to utilize all those other County or Community programs and help them apply but sometimes they're a little reticent about that because they they never envisioned that they were that person you know so then I have to try to um destigmatize it and saying well Medicare and Social Security which I've never known anybody to turn down that's from the same government as these other programs so hopefully that's a little bit of a help but they do they they didn't know that they were going to um outlive even people that have professional jobs nurses I mean a lot of people that you think would have like that plan in place it kind of evaporates when reality hits so Terry can I clarify on page 133 there's a list of seniors served um through cap um and it shows a total of 416 seniors served so um in that First Column the EAP is that what is that we should have included a uh wordage around what that acronym means um and then um so that's all of cap what is EAP oh energy assistance program okay yeah and that is a federal program but what happens is that we get the grant through the Minnesota Department of Commerce and then we cover Scott Carver Dakota and I used to be an energy assistance worker so um that is based on income it is one of our highest income eligible programs it's not based on the federal poverty guidelines it's based on the state's median 50% of the state's median income okay they get help with utilities if they're homeowner they could get furnace replacement or repair and then otherization sure Chief St uh I think Lori asked such a good question about just the challenges that you see in in working with the Aging population did you specify aging Lori um I was asking just about staying home just and those challenges for stay in home I'm wondering what you wrote some nice things in The Narrative of this document I'm wondering if you could talk a little bit about that sure so unfortunately the time that law enforcement interacts with this population is usually a bad thing um it's either a medical or Mal treatment um it could be that they were a victim of a fraud so we're trying to change that in the city of belplain by doing things like coffee with a cop um during covid we started a vulnerable adult checklist I know we should probably change the title of that but it we identified the Aging population and those with disabilities in the city and we would check in with them during Co to make sure that they were taken care of that they have their medication that they have food and water um and we still do that today so some of the officers in the city will go around to those homes and put a puzzle together with them and sometimes that's the only interaction they have with another human being for a week so the officers actually took this upon themselves to do this wasn't a direction for me it was just something that they started so um we're all going to get there at some point nobody in this room is getting younger so the programs we start today will affect us when we get to that age thank you it was it was striking to me in the right up on just on page two of your second bullet point um where you wrote about coffee with a cop and police meeting monthly to answer questions and the part that really resonated with me was listen to stories from the past and let them know we're here for them and we in other Sky County delivers conversations we hear about the lack of Youth connection to caring adults but it's it's probably I mean you just made me think it's probably everybody in our community that needs the people who are interacting with them to let them know we're we're here if you need us and there are people in your community who care about you right yeah that's the thing I mean we're we're dealing with the greatest generation of all time so when they say they tell you a story for the third or fourth time it's the same exact story you listen to it like it's the first time and you laugh at the jokes and I mean that's what we're here for so that we build that connection with the public and it's not just the Aging population it could be a young kid that sees us interacting with a older person and comes and en joins conversation so I do think that it's a a way to build the bridge right we I'd like to jump to page 32 we hit on something talking about a difficulty of staying in homes as people age and it seems like a related slide so I want to focus in on that so looking at this data in the share of households paying more than 30% of their income for housing how are we assessing this and does that include just things like a mortgage or does that include things like mortgage taxes and HOA all the costs um as we talked about mortgage uh rates maybe locked in but insurance costs for everyone are going up significantly and that's having a huge impact on people's capability to pay their rent so the uh this slide and the one immediately afterwards right I think they fit together so well one is going to specifically look at those that are renters whereas this one is broadly for all Scott County households it is typically inclusive of all of those housing expenses so if you're a rener it might include renters insurance if you're an owner it might include ownership costs uh we would look to ensure that utilities are included within that and it's generally a measure of of the typical rates that people are paying both in mortgages and in rental amounts as well as the kind of typical income ranges that a community might hold and so that's how Minnesota Compass comes up with the uh data available on that that first form seeing the insurance rate increases we recognize that that's going to be something that is going to hit hard probably in 2023 and 2024 numbers I think we're hearing a lot about it in uh affordable rental communities as well as it's making it increasingly more challenging to get some of those uh subsidized rental properties up and off the ground I was talking to a retired person who lives in my neighborhood and uh as we were talking about just how expensive life is getting they were talking about their HOA dues that they pay and how uh when they purchase their home those home that homeowners association uh fee was somewhere around $100 a month and now they're over $400 a month um which is a huge increase in something they simply can't control so what's the future look like for these uh Services we're delivering and what do we what do we expect to see when we see the 23 through 25 numbers well first I want to uphold that through the latest legislative session we had some opportunities for some uh newer mechanisms of homelessness prevention and housing retention resources and I think as we move forward into the next year there will be a lot of conversations and some very real intentionality to ensure that we're deploying them in ways that make sense to meet the needs of our community members I think um ensuring that there are opportunities for homeowners will really need to be an area of focus whether that's folks who um might struggle to pay for their taxes might struggle with some of those Insurance costs we're going to have to consider those as we would have otherwise just focused on mortgage and Rental expenses and um it's it's going to be a challenge so I'm certainly not here to Short change that but I think we are excited uh to see some of these new opportunities come to Scott County to um be able to De deliver new new programming or um ensure that the programming that we're offering today can be a little bit more robust to meet some of those raising costs certainly not here to suggest that they meet them all by any stretch but uh again I I think there are some cool opportunities on the immediate Horizon thank you insurance though was going to be a topic for all of us across the country as we think about what the future will hold um I would advocate for more senior housing just because I talk with so many people that they're when I ask what their income is and then I do ask with their rent I mean I have people paying 80% of their social security for their rent and I'm I'm like you realize that's not sustainable and so they're their living um is really compromised they're their daily living they're really cutting out of a lot of things um that are essential so then I try to advocate for other things a lot of them don't want to move um they like where they're living even if it is a really expensive apartment it's probably friends are there they got used it costs a lot of money to move I just had a call yesterday where asking if I help moving we don't do that so our help is to really help seniors age in place but we do recognize that sometimes it's just they cannot afford where they're living some of them have High um assets so their savings is high so they're using their savings to supplement that rent every month I said you realize you're going to run out of that she goes yes I know in four months in four four years or four months whatever so they some of them are planning and some of them aren't it's um so I do think we need more I think the housing to be built would I know that's more time consuming but then it would be built for seniors so that would be really optimal if we had more of those 30% of your of your income for your rent but even the voucher system I mean that could be expanded I mean then they could live Easier where there are so that that seems to be what I see the biggest cost is housing what are some of those other impacts when you see people who are just surviving and not thriving because of that cost well my to brag I mean my daughter's a pharmacist at you know so she sees people cutting back on their medications and I tell people when I used to do the snap Outreach uh you can um take all your medicine you want but if you're not eating healthy you're not going to be a healthy person so they do cut back on I mean food they come back on their medications they come back on things that they it's really we would consider essential so I sometimes can do a budget with them but sometimes there's not a lot of wiggle room and that's when I try to get them if they're eligible for these other programs and that takes a little bit of time but I can I can help them do that we go to page 26 please so we have the the screen to the adult protection reports screened in and we have 20 16 177% then the about this measure on the left it says the national average is about 59% screened in are our numbers good are they bad are they there's no reason to assign any value to them just what they're just accurate can you explain sort of where we are and what that means to you in comparison to that national average sure um thank you for bringing up this question what does this mean what you're looking at is just this is the raw data it is what it is this is factual um so over time let me explain the graph first um the blue bar that is representing just all of the reports that Scott County has received through the mark system which is the Minnesota adult abuse Reporting Center um every morning the adult protection and the intake team they meet to screen all of the reports that have come in um there is set criteria by the state of Minnesota um set criteria for what meets uh we call it now an assessment for us to our staff to go out respond um assess the situation and and determine if they need help or an investigation and so that's the blue bar the green and the yellow represent what we've actually um screened in or determined it requires some type of response um so depends on who you're asking Jake if is is this good or what does this mean um our screenin percentages have been fairly stable I would say over the years um but what the state of Minnesota is um there there has been a philosophy shift there's been some legislative changes and what they are requesting of us now is to offer a more um proactive and protective response whereas historically uh we really we were doing investigations we were determining who was at fault or if there was someone at fault um and ALS and also providing protective measures um so as the state moves us to or changes that philosophy there's been a lot of talk about getting the state of Minnesota closer to that national average of 59% so if we're currently sitting at 177% of screenin and they want us closer to 59 that's a real big gap um and so I think there's some I think good conversation and exploration to do there around what is the County's role and if we are to shift in that direction what would that take thank you yeah that's uh and chief Ste go ahead look yeah I was just going to say for for our city whether it's screened in or screened out just like child protection cases we investigate every one of them so we we like the help of the county but uh we will investigate any any report that comes in so you're going out on all of these we do okay all right um Britney can you I I think your team has done some good work this year around setting some performance markers and some data that we'll be able to bring to the board next year around timeliness of responses can you just describe that work and and the direction you're going with that sure um at the state level so the state of Minnesota they don't have any requirements on time as far as how quickly we get out and respond um the state guideline is that we begin an assessment within 72 or 24 hours but how they Define beginning and assessment varies um for Scott County what we've determined is it's important to get out there and actually see people and assess the situation um as opposed to making phone calls and and coordinating with other people like Eyes On First has been our priority and so the last couple of years um we've taken made a decision that we want to get out there within 3 days um so historically it has been and we're going to attempt to do that um sometimes people aren't home these are these are adults so they they have lives and we uh generally these have been unannounced visits we're not planning uh we're not calling them and coordinating a visit so we just show up um that is successful sum of the time what we are switching that to in 2024 is that our measure will be that we're actually completing those within three business days rather than focusing on just the attempt nice and how does that land for you if their timelines shorten how what's the capabilities or the capacity of the law enforcement Partners to respond so we just respond immediately to the call we'll work with um adult protection on the case to see where we're at uh so we don't interfere but we um I just feel a need that we have to get out on that call right away and at least talk to the reporting party if they're um not Anonymous but um check on the person and report back to adult protection so we we do work together very well if it's it turns out to be a larger investigation um having adult protection on your side is much easier for law enforcement uh they have access to more reports and data that would take us um the court process in order to get so working together is always a better um solution for law enforcement and adult protection thank you just one more quick followup does the police response vary by department or jurisdictional area or is that pretty standard in what happens with those blue I can't speak for any other Chief but I know there are Chiefs that will respond to all of them um and there's just some that will rely on adult protection I think it's based on maybe the population and size of the city and whether or not they can free up a detective to go out there and look but um in my department we train everybody in field training to to be a detective so when there may be a time when you're by yourself and you're going to have to handle every case so when you're going through field training you're learning how to write a search warrant you're learning how to investigate photograph so the officer that is call it gets that can respond to the house and take care of it like to move us to page 23 we haven't heard from Patty yet so looking at the data of what's defined as underutilization or over represented populations in the Parks uh is a big part of that just the proximity we see that you know people who are in Prior Lake Spring Lake Credit River Township uh are over represented in use of parks uh but knowing that we have really clear and Murphy and Spring Lake parks that are these really well built out amazing parks that are accessible uh is that what skewing these numbers or are there other factors that would show why certain people are attending parks and not yeah thank for the question I do think that that's a foundational piece of it is proximity um there are other factors involved so if you have a playground for instance at a park you're probably going to attract younger kids um if you have a park with only you miles and miles of trails but no benches and accessible parking that may have an influence on who's going to come but I do think geography definely has peddy just as a followup so this date is pretty old but can you talk about why we included it in this packet and what it says to you about the populations we're talking sure absolutely so generally speaking we at Scott County Parks and this is not um different from our you know Sister organizations across the Metro don't have readily available demographic information on who's using our facility so when people walk into a park or a program are not asking them what's your income what age are you you know all that kind of stuff and there's an opportunity every five years where we do a really um in-depth study so our partners through Park District does that every five years so U the last time we have that data available from 2018 um the visitor survey was um implemented last year it's an immense amount of data and it's all analyzed inhouse at Three Rivers so they're still compiling all the data looking at it and generating reports so I'm hopeful um towards the end of 2024 we'll have the 23 data we'll be able to compare it to the 2013 2018 um and see what kind of Trends are we're seeing so am I right when I look at this data to say that um aging residents and residents with disabilities um we're not we're neither under represented or over represented that is what the data was telling in 2018 YK thank you can we go to page 29 please so the numbers that the the numbers over that 5year span that change is is significant so I just wanted to know if you could talk a little bit about some of the drivers are we looking at just the number of people are changing just the costs are driving those numbers to change so much is it a combination just from your varing perspectives what's driving that large number change what I can say this is a slide from our Income Maintenance um department they are not on our panel um so I can't speak to this specifically um but I believe um what they have shared is that due to just the growth of the county um we are um um anticipating to see that these numbers are going okay goe sorry yes I would say also due to the pandemic and the fact that we had to weren't doing the redetermination [Music] process so can I just a follow up so if if it was a symptomatic of the um the uh cuse on redeterminations do you anticipate that this data is going to level off we are starting to see those numers from 2020 at the beginning of 2020 still up about 20% um of the number of individuals to um to what we saw the peak of the pmic and actually at the end of last year deci because what 31,000 individuals that were onist I think that number as of last month was 2,000 as we're seeing that come down I think some of the work Still Remains having to go through really about three different processes right now try go through that redetermination process I'm hoping that that levels off and end next year I think one of the things that with this slide though that you're going to see is you have the number of individuals that have a disability um and the expense that's related to that that that continues um once individuals are it is hard having a disability enough to have wavered Services um and once they have that eligibility status they tend to stay that where we're seeing adults thank you is it really matter um I'm I'm not a medical expert um I used to do the for one year I was an Affordable Care Act I was a um inure Navigator and then through my experience I mean it would this made perfect sense when I read through this that disabled people would have more medical expenses same as for the elderly um the thing too is I think there was a pause from the pandemic that they didn't make people reup their medical um and so same thing for snap we saw the big cut off when the pandemic declaration had ended a lot of people were really hurt by not having that full benefit of the snap amount each month so we've seen a surge in our Food Shelf um the numbers I mean it's it's really really hard to overestimate how many people are coming now to our food shelf it is a safety net because they're not eligible income wise with snap um they uh maybe they're not old enough to get our hom delivered meals but they can come to our food shelf anybody in Scott County can come to our food shelf we don't um we can ask them their income but there's no barriers to that so um we're seeing like a couple week appointment out uh for the food shelf but they can have the drive up service that was the model that was implemented with the with the pandemic um so that can they still be same day but this was not surprising to me because um so many people are needing of um health services and with the disabled I mean when I get to see from the waiver people that are um sent to me that chore typically tries to help people that are not on a waiver but then we can utilize because we get reimbursed by either their insurance or the county I get to see some of their plans their life uh choices plans and they have a lot of disability codes things that um they really need help with and all that all those Professional Services are expensive so that that makes sense to me my workers that work for me or my volunteers um we don't train them on mental health issues we don't train them that uh they're there to clean they're there to clean the snow but I do tell them try to be understanding you don't have to take abuse people can be crabby maybe they you know uh are feeling well um but um they they do have a lot of issues so I I try to mitigate that for them but I I can I when I read through this Sunday I could definitely see everything seemed to make sense to me and then when you were talking about the case loads and people being um why there was a gap in Services I could see that they had a lot of retirements you have new staff it takes I mean just speaking from myself for 34 years you know it takes a long time to develop skills and you're not going to know everything on day one and there's things that are not taught to you that you get to learn being on the job you know so I could see why this would make sense thank you um I think uh Central to a lot of this the material in these packets is um some of the challenges surrounding in choices and so if we could go to page 16 um um I think the narrative spelled out some of the some of the challenges around meeting the demand for service um but I wanted to give you a chance to speak both to the demands and I thought there were some really strong examples of efforts to mitigate the demand um through some of the reorgs and cross training and some of the things you're doing internally to try to to try to um manage that so um on page 16 this is a breakdown then of what are the new assessments coming in in choices as well as the reassessments and so can you talk a little bit about that sure I want to clarify one thing in the about the measure um section on the left um the language says here that an assessment takes um 8 to 12 hours to complete that was for men choices 1.0 for the current men choices 2.0 it's more like 15 hours um so I just want to clarify that part first um what you're seeing in the bar graph and you will hear a lot more about this in a uh a board Workshop in July but what you're seeing on this bar graph is the number of annual assessments we complete um once a person is eligible um they have to be reassessed every year um so the blue is showing how many reassessments have been completed the gold is showing the brand new assessments we've gotten a new referral that's come in um the gold is really dependent on our internal capacity we have to do the blue we have to do the reassessment so people don't lose their eligibility if we have time currently that's when we've been um deploying our efforts to doing those new assessments um so this graph doesn't show the full what the need is it's just showing what we've been able to complete what happens to people that you can't assess well I don't think it's news but um we do have a way waiting list right now um we have sh what is the current waiting list as of yesterday we're up to 281 people on our wait list and we still have people from November of 2023 who have not been assessed yet because we can't get to them the Department of Human Services has given us some priorities over who gets screenings before others and that includes like individuals who are discharging from institutions we have to get to them we cannot say we're going to put you on hold individuals who are currently in assisted living facilities who were um there probably under private pay status and now have run out of money we don't want them to get evicted we want them to continue to get those services and supports that they were getting so those are a priority for us and also individuals who um are open to case management and the individual now needs placement and they have found a placement we kind of push those through as quickly as possible to make sure that um they continue to be safe and then everybody else it's how they fall on the list so two questions one is do the priority areas that the state set like how does that land for your team and your department like are their priorities our priorities yes okay and we used to be able to get out within like two to three days we're now up on an average of eight days were the priority assessments correct for the priority assessments so then my second question goes again is what happens to these people while they're sitting on a waiting list well um you will see that in our July presentation but um just in 2023 175 people fell off of our waiting list because they either passed away they no longer needed the services they had to depend on families you know or neighbors um um to help them until we can get out there I'm trying to think of some of the other things that we have seen um some individuals end up moving to another County because they can't afford to continue living where they are and they move to another County so we don't know what happens to them okay and a lot of people they just try to hold it together until we can get out there yeah like for instance yesterday and it's still fresh we had actually a family who has been on our weight list since January show up to the HHS Lobby refusing to leave until they were able to talk to somebody and get some support and so thank goodness um that person is eligible for developmental disabilities has been deemed eligible but the last part of that eligibility determination is our assessment and we can't get to them but someone on um Melissa's team jumped in and talked to the individuals started providing them with some resources that they can start looking at right now um because they are certified disabled and they're open to medical assistance and those resources are available to people who are open to medical assistance and don't need to have an assessment okay and then they're going to be looking at potentially another program that does not require our assessment okay try to put a bandaid on it for a short period of time till we can get to them okay so shoner Britney talk a little bit about that extra time you said that the time for assessments 1.0 to 2.0 has almost doubled is that good time are we getting additional information does that enable us to to help the clients better can you talk about that a little bit no that's not good time this is additional time that the assessors need to spend on workarounds because the new tool that was launched has a lot of faults and when they fix one area another one goes down and then sometimes what ends up happening is we stumble across it and it affects eligibility so we then have to figure out what happened we have to report it to the state who then puts it on their list of fixes and I'll tell you when they launched in July of 2023 there were like 51 fixes on their list after the first three months it went up to 150 fixes and it just continues to keep rolling when they fix one thing it affects another and so there's all this additional time that the assessors have to spend trying to figure out what happened that may have affected somebody's budget because they have the right to appeal and then the assessors have to go to the appeals to explain to the administrative law judges why the budgets went down we go to slide 22 please Jake do you mind if I ask one followup before we move on can I do that thank you um I'm wondering um because one of the things I think was important in the narrative was that these waiting lists exist across the Metro this isn't a unique to Scot County um feature so can you talk about like it really does seem like a system level fix more than you know a fix that your team is going to do right so like are there conversations regionally about or legislatively like what it it feels like a problem we're not going to outrun so I'm wondering what your thoughts are around the bigger conversations and maybe you want to save that for the workshop would you prefer to do that I just thought of that I'll I'll talk about it both times okay um there was some legislation that just passed in in this last session that extended the initial timeline um we the state guidelines used to be you had 20 business days to get out and do that initial assessment that has now been extended excuse me saying that backwards it was 20 calendar days now it's now it's 20 business days um in addition one change that has happened is the assessment is now good for 365 days instead of expiring after 60 that's important because that that reduces some of the repeat assessments that we needed to do so those are two good things but the the bigger piece that did not pass in 2024 was reducing U the frequency of those reassessments um so right now they have to be done annually there was a lot of conversation about reducing those to every other year or something else that would have a significant impact on staff time um that did not pass but I'm hopeful that that will we will continue to push that forward um this next session but maybe shy you can talk about what some of the system issues are that um counties or the region are are talking through or DHS is talking um with counties about the one thing that I'm want to piggy back on something that um Britney had talked about the legislative um legislation passing it still requires Federal approval we just can't implement it so the Department of Human Services has to write up an amendment to our federal waiver amendments to make that request to the centers for Medicaid and Medicare services to implement those changes and if they say no then we can't move forward with anything okay and that and that is a stop clarifier and and that's a stop G for us um to answer I'm not sure if I'm fully understanding what Britney's saying but the counties we have a metro men choices lead agency meeting we get together and we're we're always talking about the challenges we're facing and and we shareed tips and tricks on how we've worked around some of those challenges and then we provided to the Department of Human Services to say these are some of the things that are big challenges for us we need your help the Department of Human Services now has received a grant to have um I don't remember the name of the company but it's PCG to come in and evaluate um some of the supports that are going on and what are some of the barriers and challenges that the counties are um experience as a result of administering these programs the um Scott County participated in one of those um reviews um a year ago didn't really tell us a lot to make um some significant changes but there's now another focus group that's coming up where they're going to be talking about system changes and some of the barriers on presumptive eligibility and so we're encouraging staff and also as supervisors to um register to be part and hopefully selected to be part of these forus groups so we can make those recommendations to the state that this is how and what can make our jobs easier and we can get things done faster um one of the things that has been also challenging for us is last year there was a legislative change that was made that um the teer fees the parental fees for individuals going um on medical assistance if they were kids that their parents didn't have to pay a fee anymore and so that was really helpful to the families but it also increased the amount of work because individuals who say no I don't want to pay that high parental fee are now coming through saying yep let's move forward you know it's time we could really use the help and so that is also increasing our case loads we've also seen um in the past two years five large assisted livings open up in Scott County and while most of them will take um private pay for the first two years now they're getting to the end of their two years and we've seen a huge increase in the number of elderly who are calling that um meet the elderly waiver to be able to continue to live there and that affects us as well thank you all right Jake thank you could we actually go to page 11 in instead [Music] sorry um so one one of the things that I didn't see and I think there there's probably a reason for it there's a lot of information here already so you have to put boundaries on the conversation um which may be tips like I'm going to ask a question that doesn't have anything to do with what was in the packet and the data but as you look at the the first goal you listed is preparing for growth that's that's the goal you're trying to accomplish bringing folks together you're looking to the future I think census projections planning okay what does that mean is our population ages and gets more complex how do we serve those folks what I didn't see anywhere in the packet was the impacts and supports and opportunities for all the caregivers for both for both of these populations both people with disabilities and older adults and I I think as I look at we're going to have more and more older adults in our community there's opportunity there probably from an entrepreneurship standpoint to try to be creative and maybe that's something regionally that should be looked at um and also just what are what are what are those three I should just stick with my original question what are what are the three things the impacts on caregivers who are working in this space both the folks who are paid to be caregivers and the people who are working um I imagine like the Terry fermans of the world just showing up with all their skills and all their gifts doing what they can to make a difference for people um folks Like Chief steer and his his crew so so what are the supports for the paid unpaid caregivers what are the impacts on those people and then what do you see as opportunities going forward as you've had these conversations for a few months to prepare for today you get to know each other's programs what's going well what isn't what are the opportunities for for the caregivers in this space over the next 10 or 20 years I I will just add it's not something that has not been an area of focus um when we're talking we programs there's a there's a set list of services that are offered um caregiver support is a small component of that but previously in HHS that's not an area where we focused on um us providing um that service there's certainly are a lot of community organizations that offer support groups when we hear about them um you know we're sending that information out to staff so they can share with those that they're engaging um but the community folks may have more to say about um what is out there that certainly is something that we will need to focus on just even in preparation for this um the question about what happens while people are waiting um what we hear is um they're relying on family and friends there's that caregiver burnout piece um I Heard two stories really recently about um parents that have lost their jobs or at risk of losing jobs because they have to stay home and take care of their kid while they're waiting for more support so there are a lot of impacts there it is something we need to pay attention to um I just don't know that there's been a a focused um attention made um from the county side yet Carol do you see any of those caregiver supports in the work that you do yes y I share information we've got a couple organizations that I hear from um that I always send right to Britney to share with her team in regards to um caregivers support some great organizations out there um Normandale Community College has a great organization that works with the caregivers I get a lot of requests sometimes for um caregiver respit so that caregiver needs to get out of the house because they've been there taking care of the family can you just give me three hours to go to the grocery store by myself and I'll find a volunteer that will go and sit with them um but I think there there is obviously a big need for that and we're seeing that I think CommunityWide and partnership wide that there are a lot of orgs that are kind of starting up to help to fill that need thank you Jake did you get your questions answered did you have more you want to follow up on that no that's good if it's helpful I'll say I think it makes sense too to just look even at our fish requests right we often see requests come in from community members who are identifying that they're um missing work missing opportunities for school or for increased aded um as a result of some of these needs around caregiving and we're seeing the impacts come out certainly within housing related requests but I'm sure it's it's probably true for a lot of the the programming that Terry might operate at cap as well thanks can we go to page 22 um Paula I was really happy you know I worked in Scott County a long time and I was an interim Library director and I didn't know that any of these things were happening um and so I was really appreciative that you guys pulled this data together um about those supports that the library is providing as part of that support network and that safety Network um as your team thinks about the growth in the Aging population like how are your teams talking about what what kinds of services might continue going forward I think at this point we're um looking at um things like technology I was interested in what um I know um Chief here was talking about as far as helping with computer literacy and that sort of thing I think that's something that we could be very it's very much part of our job um we are not techie um experts by any means but when people come into the library and they need help then we do the best we can um and that is usually involving helping them get on and off computers and printing and all of the things um like that I think it's really important for especially folks that are aging because there's a a good-sized population um that doesn't get online for everything it's not part of their culture really I mean um the phone the phones that they have they don't understand they just want them to be able to call in and out and that you know save some numbers would be good um so they they may not realize or just don't think to go to technology and Technology will make it so much easier for them to get those services that they need and to contact folks um the phone books are like kind of a thing of the past um same sort of thing so I think the technology angle um we'd like to pursue um we also know that there are folks that can't physically get to the library and so um we started um a program called library to you uh we focused on um people that were living in assisted living facilities in particular where um perhaps their facility would be able to take them to the library but it doesn't seem like that really happens we don't see large groups of people coming in from any any senior facility to speak of um unless they are in the same building as the library which a couple of our libraries are like that um so we are we're taking materials out to them then Along Came the pandemic um and that really threw a monkey wrench in that we are slowly coming back from that um but we would also at this point we're piloting a program um whereby we we are using um car matson's uh County volunteers or in the process of doing this um and we're pting a program where the volunteers can take materials out and pick up from folks living in their own individual homes it does not have to be you do not have to be in a facility which I think is going to reach those folks that can't afford to be in an assisted living facility um or maybe haven't gotten there yet but they still have disabilities that prevent them from moving around um I think think um another thing is just connection with the community um I I think that's really missing and I would like to concentrate um I'd like us to concentrate more on that um it's great for people again who can come in but what about the people who can't sure um are there are there programs we can do online again that technology piece right so there's a lot to kind of pick at and look at for what we can offer to folks but we want them to feel a part of their Community they are a part of their Community they just it's harder for them to be in that community so that's great thanks all right I'm going to give one last question to the facilitators on the topic of um our seniors in technology uh as we looked at the narrative from Chief steer who talked about law enforcement often ends up on the tail and of a scam or a a problem what's the opportunity that we have uh either with the interactions with law enforcement or in our libraries to help educate seniors about all of the I mean the ridiculous number of phone and online scams that are occurring and um as we talked about as as people's uh flexible spending is getting Tighter and Tighter and Tighter having just one victim of a scam could push someone from being self-sufficient to being in need of a lot of services so what what's the opportunity and what's uh what do it look like now and in the future for an Outreach opport to help prevent that victimization well from a law enforcement perspective I don't might not fall into our category but what I would like to do is have some Town Hall meetings where we can bring everybody together and go through just your basic 101 of a this is a cell phone this is how you send a text message this is a a scam um if it comes an unknown number potential scam what does that mean do you answer the phone just a very Bas level conversation and then have those um multiple meetings with people just to explain now this is a laptop computer I'll use my parents for example it's uh hopefully they're not watching but it's like once a week I get a phone call of I just got a scam call or I have a warrant out of Texas you know and it's like no you don't have a warrant out of Texas it's just don't pay the money but those are are 81 and 82 they worked hard their whole life and they could fall Vic to a scam of you know send us $6,000 in uh gift cards you know into them it's I have to get out of this you know I don't want to be in trouble but you're not in trouble to begin with but how do you get the message out there that you're not so I think it's going to take a lot of uh cooperation and it's going to take a lot of people to bring people together into a town hall meeting and we could do an online but most people don't know how to get online so um it's it's going to be a challenge to try and get everybody together to try and fix the problem I was going to say now unfortunately with the uh cease of the local newspapers I think there could be other ways to reach people um you know most people still get a utility bill they might not um some people do have auto pay or they get it online but we're trying to reach the folks who still get the paper utility bill maybe we could have a little blurb in there to talk about the scam I mean just you have to tell somebody sometimes three four times before it will actually sink in um sometimes um cuz I do work from home and I live with my daughter um I sonin-law my three grandkids and sometimes they're like why are you looking up the Comcast phone number for this person I'm like cuz I'm 411 you know they don't know how to call so they're calling me to in order to assess these but I think that would be a good way to have that whatever what seniors are still looking at it's it's their maale what what if they don't can't come to the town hall you know what I mean what what are multip places that people I know not every everybody reads their utility bill um but I mean they should but I mean they some wherever seniors are getting their information do that so that they can see that because I have gotten the the scam and I having a last name of Hassen um uh my ex-husband is from Iraq and so sometimes I get calls saying you're going to be deported you know and I said no I'm not you know so I mean they will and it'll be the number from Washington DC you'll say that I have back taxes I have all I have none of those so I don't have to be fearful and I even say shame on you why are you doing this you know what I mean but they don't care you know but I mean they're they're thinking they're calling somebody who is an immigrant somebody who doesn't know better I'm going to be 65 this year I've been getting a lot more mail things that um that they think that would be pertain to me free dinner and then we're going to talk to about Medicare and I'm like I know all about Medicare I used to be Medicare counselor so you know what I mean I just throw those away but I mean a lot of people do do fall for those which is unfortunate I just want to add really quickly to like this is a topic area as we've been doing some exploration of a potential um fiveyear plan for Aging Services um we've we've met with a a lot of different departments the county attorney's office you what we hear from Sarah wendorf too is that these scams um they require so much staff time um from law enforcement adult protection case management but it it they're very what I understand is they're very complicated to prosecute too um and so it would be in in all of our best effort interests to um do a little some more ed Community Education about it prevention yes all right on that note Madam chair thank you very much this was a wonderful presentation I think we've all been interested in learning more about this we need to hear more we need to make some of these connections that I think were made today colleagues questions commissioner alich I've got a couple radically different categories of uh questions or and one comment generally listening I I think it would be an excellent scale topic if you had a topic of Community Resources for seniors not redoing this exact presentation but pulling out what would be really key resources for seniors I think that would be very valuable to scale and I do want to compliment and and I've long been impressed with the ban bplan Poli department but I'm just wondering uh Chief uh St if if you have an opportunity and you're meeting with other Chiefs to to share ideas of what you're doing for seniors I mean that is really you're being very proactive and taking great steps do you have an opportunity or or how could that what you're doing there spread to all the departments in the county help yeah I think uh so we have our Scott and Carver Chiefs meetings uh once a month I can bring it up there just get different ideas and um some of the things I'm doing I'm stealing from other people uh so I'm not going to say that I I'm a big groundbreaker guy but uh I know most Chiefs and they want to do um what's right for their communities it's just a matter of time and resources so uh I I have the ability to utilize my resources a little bit more than say a Shaka or Savage um that they're going call to call so we have more of an interaction with our public um and that's just the population uh but yes I would love to bring it up I'm also on the Minnesota Chiefs of Police Association board and I can bring it up at that um state level as well to see if there's something that I'm doing that they could use or I can bring something back great one one other this is for Shauna um I'm aware of um type of situation where a senior would start off as private pay at a facility and be told they do take elderly waiver but when the time comes when they run out of money they don't have a slot they only have in a larger facility may have one or two or three or four what whatever slots for Le waiver I guess I'm wondering is there something that should be done when these facilities are being built I mean is there some way we can require facility to more have more than you know a couple percent worth of elderly waiver spots in their facility you know because you said and and I I'm aware of it where people be you know living this County maybe most their lives and then they run out of money and they have to move to H up in a Dakota County because that's where an elderly waiver spoted what's the solution there or is there any we should be doing differently that's an interesting question because several years ago when the county used to contract directly with these Assisted Living providers we used to say you have to take a minimum of these many people before we will contract with you and then when the state took over the contracts per direction from the Feds that all went away so they have the right to choose choose how many people they will take on public assistance and it's very unfortunate because even when we're talking them during intake and they say to us yep we're now running out of money and we're told we need to call you because we need to get on the Lulu waiver and they're already living in the facility will'll say to them did you have a conversation with the facility yet to see if they will keep you under the L waiver and they go well our contract says that they will we've had historically con um convers ations with these Facility Owners and they'll say our contract just says that we'll find a place for you but it doesn't say that we will accept the elderly waiver so you can stay where you are so a big facility may have another facility in a different County and they'll say we have an elderly waiver bed open there if you want to use the ELD waiver you'll have to move there yeah it's totally out of our hands we cannot tell them you know if they want to open up private pay and then later go to the Medicaid programs that's totally their choice so the elderly waiver will often pay for the services and then when we look at those room and board expenses that's typically through a program called housing support it used to be called gr group residential housing and I think we're having a lot of intentional conversations internally right now around our Contracting processes and how we can ensure that there's adequate capacity not only within our financial eligibility team to process increased requests for housing support but also to uh support the providers that are operating these settings so that they know what the expectations look like and how to ensure that these folks can can continue to uh be able to receive that benefit set in those facilities but yes to your point absolutely we see your array or what Peter was talking about too is that room and board piece people think that the entire L waiver program is going to pay for their room and board and we have to say that's a separate piece that you are responsible for and then so sometimes what the provider does is to make up for the loss of going to the elderly waiver rate from private pay they'll increase their room and board rate and they can't afford that so that's many times when Peter gets involved or our economic assistance saying what can you do to help us so we don't have to move really good question really good answers and that is a much bigger philosophical economy question that we we are going to have to solve more so thank you commiss thank you thank you um kind of ended the conversation on scams uh and that is taxing on local official staff but it feels like like it is becoming a much bigger to-do nationally so are you aware of any any movement that the feds are looking at because it costs all of us money you take someone's life savings and all of a sudden the collective Wii are now standing in the Gap and I know trying to find those IP addresses in Tim Buck 3 are very difficult after they're bounced around but um are you aware of anything any movement no so the BCA uh Bureau of Criminal apprehension in St Paul they used to have a uh a task force that you would send all frauds to and they would just investigate it and the pile got bigger and bigger and bigger and the Staffing got smaller and smaller so now they're trying to bring that back up a little bit um Technology's helped us out a lot for um sending out like we have a victim of a fraud of the warrant scam so then it would be bplan has one Shak has one now Maple Grove has one so let let's form it all together the fusion Center uh helps us with that so all the information together investigators working together the problem is the IP addresses and once the money's gone it's gone so you're looking at a victim and you have to tell them you know you're a victim of a scam which is a the first hit and the second hit is we can't get your money back and if we do we're tracking it back into a different country for the most part so that is impossible to prosecute so I think there there's a plan in place it's just not um not there yet I've seen some public service announcements for the U Medicare they said do not give out your Medicare number I mean I think you need to do that more because seniors do I mean most watch uh TV so I think they need to do that more and just letting people know these we don't want to give ideas to scammers but I think the ideas already out but anytime you don't recognize um I get a lot of people that want to call me for donations and I said can you send me something in the mail so I can look it over I don't want to give my credit card I'm sure Operation Smile is a good outfit I do I do contribute to different charities but um I said can I get something in the mail so I can look at it and then I can write a check you know and that type of thing so I think can't have too many of those yeah I think the the scammers are I mean this is their job that's all they do so they're doing a lot of research and they're finding that person that just lost a spouse and they're hitting him at the most vulnerable time in their life and maybe family at that point is not so not around and they they know like you just lost your spouse I know your son is going to school here they're very convincing when they ask for money and that that's what they do I mean and if they get money you get on the list and then everybody's going after that same person is what we see so it's U I would love to be able to stop it but it's just one of the things that it's out there so there's no smart bomb that can sniff out that IP address to yet I'm sure there is can't prute him nobody's given to us that is Prosecuting but that's a that's my own opinion thank you I I just have a I have a lot of questions but the one I I'll just focus on is are we monitoring the nursing homes and service provider ERS to make sure that they have that they're going to be able to continue being in service and have the Staffing um in place to to provide um services to those people I know Staffing was a big issue I know that the state increased the minimum wage but I still hear about issues with Staffing um in in our day services and our nursing homes so do you see is that something that we track and monitor and what happens if that nursing home or facility closes to our residents who are receiving Services between the Minnesota Department of Health and our internal licensing department there is a lot of monitoring of those facilities situations still occur where facilities will close or where um an entity will have to purchase the full portfolio of another provider I recognize that that was a pretty big one for our communities that we navigated in the last 24 months um when situations like that arise where the folks are accessing County case management I think there's a lot of coordinating efforts to try to find new facilities for those residents and it doesn't always fall to the facility itself to do unfortunately um in situations where those sites uh might be full of folks who don't have as many connections to Services it can be more of a scramble um I can confirm that we've seen both but uh again between the Minnesota Department of Health and our internal licensing there are pretty frequent interactions with many of the facilities that we have operational in Scott County right now well I cannot speak to what happens with the nursing homes and their Staffing I can say that the Department of Human Services has has changed as a result of being more person centered that with the assisted living facilities it used to be only their their facility staff who could provide services they've now made it that an individual could have help come in so instead of getting the one bath a week because that's all their staff can handle they can now have somebody part of their elderly waiver um service plan um have somebody come in to give them bath more frequently or to come in clean their home and then the rate that is being paid to the facility is lowered so we don't have any duplication of services so that that is a plus for people in the assisted livings but it's no help to individuals who are in the nursing homes I have one more comment if that's okay I I just want to make a comment um my daughter tends proact for day services in the read mobile goes to proact couple times a month and we ran into um the staff person at the Shak Library the other day and she was just so thrilled um that's such a big p part of her life is having the REM mobile show up at proax so I'm glad that's a service that that's out there and yeah so thank you that's that's all commissioner wolf all right I have some comments but I will share them um in another way thank you to everyone I hope we made some connections here because this is an important growing uh topic that I think we're all deal dealing with thank you for being here today and thank you for doing this really good work