The Cook County Public Health and Human Services department provides essential services to county residents. The department is organized into two primary areas: human services (including adult and home & community based services, children and family services and economic assistance and health care programs) and public health. Staff also provides fiscal and administrative support across all program areas. PHHS staff work together and with community partners in tribal public health and human services, primary health care and nonprofit service agencies to fulfill our mission of supporting the health, safety, and wellbeing of the community. The department receives oversight from the Public Health and Human Services Board, which includes the five elected county commissioners, and two appointed community members from the PHHS Advisory Council and Cook County Local Advisory Council for Children’s and Adult Mental Health. Cook County is also a member of the four-county Community Health Board with Carlton, Lake and St. Louis counties.
State Supervised, County Administered Human Services Programs
In the state of Minnesota, mandated human services program delivery is delegated to county agencies. Federal and State law define what services must be provided. The Minnesota Department of Human Services (DHS) has responsibility for developing policy and guidance for human services programs while most of the direct program administration and services are delivered directly to people by counties, tribes, health care or other community providers. DHS also monitors county performance across all essential human services programs including child welfare, children’s mental health, public assistance eligibility, child support, chemical dependency, adult disability, adult mental health, adult services and adult protection.
County human services agencies have a unique role in service delivery, tailoring services to meet unique local conditions. Counties are also required to support human service programs through tax levies to fill in the funding gaps left from state and federal grants and revenue.
Each year, DHS releases the County Human Service Cost Report, which combines county fiscal activity and the Minnesota Department of Human Services’ centralized fiscal activity on behalf of counties. This report provides the big picture of statewide county human services fiscal activity and is designed to present a fair and consistent representation of the costs and revenue sources involved in providing human service programs administered by the counties and supervised by DHS. According to the most recent DHS cost report from 2018, the total human services costs for Cook County was $15,523,102. State and Federal human service agencies contributed $13,807,219, or 89 percent of the revenue to fund human services programs. The majority of human services funding in Cook County and throughout the state funds health care services. Of the total $15M human services program cost in 2018, 67 percent or $10M of this cost was for health care services including health and dental care and care provided in skilled nursing facilities. $4M (27 percent) of the total human services cost in 2018 was for social services including activities directed toward the well-being of children and support and treatment of adults with mental illness and $1M (6 percent) was issued in the form of direct support to low income individuals and families.
Successful human services work involves communication and partnership between program and fiscal staff. One example of this in Cook County is our work to reduce costs and ensure the department is accessing all available revenue for services to children. Within the last several years, out of home placement costs, including payments to providers and cost to the court, were significantly reduced through adding the appropriate level staff of in the area of children and family services. Staff is working with more families on a voluntary basis to intervene early and provide support to families in preventing out of home placement. When out of home placement is determined necessary by the courts, staff across program and fiscal areas work closely together along with the family and the foster care family or provider to ensure that the agency can access all available state and federal reimbursement for the cost of care and reduce the county tax burden.
Essential Areas of Public Health Responsibility
The public health system in Minnesota functions similarly as a partnership between state and local governments. The six areas of public health responsibility for local public health include (1) assuring an adequate local public health infrastructure, (2) promoting healthy communities and healthy behaviors, (3) preventing the spread of communicable disease, (4) protecting against environmental health hazards, (5) preparing for and responding to emergencies, and (6) assuring health services.
In Cook County, public health staff coordinate activities in each of the six essential areas of public health responsibility. Much of our work is done in collaboration and through contracted service agreements with community partners. For over 20 years, Cook County has partnered with Sawtooth Mountain Clinic and North Shore Health for the delivery of public health services including public health outreach, family home visiting and home care nursing. Within the department, staff provides leadership in public health emergency preparedness and response, grant and contract management, and community health assessment and improvement planning.
Funding for public health programming is allocated by the Minnesota Department of Health (MDH) to local public health departments through the regional community health board. Of the total public health budget in 2020, 58 percent went to supporting the work of other organizations that provide essential public health services. Program and fiscal staff are required to complete monthly, quarterly and annual reports within each grant and area of public health responsibility. In addition to program and reporting requirements, the local public health act requires an assessment and planning cycle and completion of community health assessments and community health improvement plans. Cook County’s current health improvement plan is available on the public health page of the county website.
Learn more about the PHHS department at the February 16 PHHS Board Meeting at 8:30 a.m. The meeting is available to stream live on the Cook County website at www. co.cook.mn.us. You can also visit our website at www.cookcountyphhs.org, contact us via email at PHHS@co.cook.mn.us or find us on Facebook @CookCountyPHHS or Instagram @cook_ county_ phhs to learn more about our work in supporting the health, safety and wellbeing of Cook County. For the latest information on COVID-19 in Cook County, visit the comprehensive hub site at www.cookcountycovid19.org
County Connections is a column on timely topics and service information from your Cook County government. Cook County – Supporting Community Through Quality Public Service
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