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Health, human and veteran services offer annual reports

WALKER — Cass County Health, Human and Veterans Services (HHVS) presented their annual report to the county board April 3.

The department is staffed by 19 public health employees, 33 in income maintenance, 33 in social services and two in veterans services in 2011. There was a net reduction .7 full-time equivalent position in 2011.

HHVS opened an office in the land department building at Backus in October in addition to the main Walker office.

Employees processed about 1,515 intakes in 2011 for adult and children family services and have a 24 hour intake by using a cell phone connection to the sheriff’s office after regular business hours.

Social Services

The department processed 260 chemical dependency assessments in 2011, up from 219 in 2010. There was $74,288 spent on chemical dependency treatment and $114,047 on detoxification services in 2011, compared with $110,802 for treatment and $167,652 for detoxification in 2010.

HHVS Business Management Director Melanie Wolfe said HHVS does not have data to track whether the decline in detoxification costs is related to the fact there were not detox services available in Crow Wing County during the year, which might otherwise have served the southern half of Cass.

Cass did continue to use detox services at Pine Manor at Nevis and at Northland Recovery.

HHVS spent $146,904 for hold orders, poor relief and crisis beds for adult mental health services, well below the budgeted $385,000.

There also is a community support program for people diagnosed with mental illness. The budget to fund this was reduced, but services still are available to help people obtain employment, develop skills and connect with resources to meet basic needs. There was $143,575 spent in 2010 and $131,408 spent in 2011. The 2012 budget is only $114,440.

Staff processed about 105 assessments for vulnerable adults who, because of physical or mental disability or dependency on institutional services, are particularly vulnerable to maltreatment.

They managed cases for about 97 people in adult foster care or assisted living facilities who otherwise would have be move to a nursing home.

People under the Community Alternative Care, Community Alternatives for Disabled Individuals and Brain Injury waivers are in home and community based services as an alternative to promote optimal health, independence, safety and integration of a person who is chronically ill or medically fragile who otherwise would require hospital or nursing home care.

In 2011, $3,676,193 was spent in this program to serve 77 consumers.

HHVS spent $7,199,657 to serve 158 developmentally disabled people with home and community based services who met a waiver criteria. Staff also provided an additional $282,807 worth of services from county and state funds for 52 developmentally disabled persons who did not qualify for waivers.

Social services division can earn federal dollars to operate some of their programs. In 2011, there was $23,669 earned for long term care consultations, $7,490 for chemical dependency assessments, $44,128 for vulnerable adult/developmental disability targeted case management and $3,672 for developmentally disabled screenings.

Social services division provides case management for adoptions and adoption finalization and manages long term foster care for youth up to age 21.

HHVS had 52 open cases in 2011 for children’s mental health services with home and school consultations. They report an increase in requests for these services.

They processed 389 child protection services cases and 317 child welfare cases in 2011.

There was $2,480,500 spent in 2011 to place children outside their own home. Of that, $101,127 was spent on emergency shelters, $460,412 for foster homes, $706,065 for group homes, $673,286 for correctional facilities and $85,015 for miscellaneous services.

HHVS licensed about 59 child care centers in 2011, 31 child foster care centers and 50 adult foster care centers. The county checks for health, safety and the rights of those receiving services to ensure providers meet minimum standards.

Cass had a grant through 2011 to fund a special focus on child truancy (failure to addend school). Though the grant has run out, child protection social workers will continue to focus on truancy.

Minnesota Family Investment Program is the state’s welfare reform program for low income families that helps families to work by providing cash and food assistance while they transition into a self-supporting work situation from a welfare support program. Participants are expected to work.

Health Services

Public health served 535 clients with home visits and at public health clinics during 2011 for prenatal and postpartum services, family planning, premature infant assistance, pediatrics, child and teen checkups, car seat assistance, dental health and congenital anomalies.

With some families moving out of the area and birth rates down, Cass health services has seen a decline in Women, Infant and Children (WIC) program use. From a peak 905 average served per month of people served, there was a drop to a 2001 monthly average of 762.

This program provides nutrition education and funding for healthy foods for infants, young children and breast feeding mothers.

The Follow Along Program for children from birth to age three monitors child development. In 2011 228 young children were monitored, down from 330 in 2008. In 2011, 92 percent showed a normal development rate and 99 percent passed for the social emotional screenings.

Public health gave 1,250 doses of general immunizations to 925 people at 75 clinics during 2011. Another 788 people received vaccinations at 11 seasonal flu clinics. Public health attributes a decline in their seasonal flu clinic use to the wide availability of those immunizations in the community and, last year, to the mild flu season.

Cass collected 24.75 pounds of old prescriptions from residents in a partial year start to the Take It To the Box medication collection program. Boxes where residents may drop their expired and unused medications are located at the sheriff’s office at the courthouse in Walker and at Lake Shore City Police Department. Pine River is looking into joining the program.

Public health conducted 34 compliance checks in 2011 to determine whether businesses would sell tobacco products to underage customers. Seven businesses failed the test, and 27 passed.

There were 16 health nuisance complaints received in 2011. The most common was concerning mold in homes or rental properties. The county also provided 200 free radon testing kits to 200 residents in 2011.

Cass has made available to residents a TWRX discount drug program. Any resident can obtain a discount card from public health in Walker to use at their local pharmacy. At the end of 2011, 951 prescriptions had been filled using this card, with average savings of 65 percent for a $56,467.99 total savings.

Public health offers monthly child and teen checkups at Pine River, Remer, Pillager, Longville and Walker. In 2011 they saw 158 clients in 181 visits. Public health also checks infants and young children for hearing deficiencies and works with families who have birth defect special needs children.

Cass provides family planning services in partnership with Todd and Wadena Counties. Monthly clinics are held at Pine River Family Center and Essentia Clinic in Walker. Pregnancy testing is available at WIC clinics and the public health officer in Walker.

Public health provided senior foot care and blood pressure screening for 529 clients at monthly clinics throughout the county.

The senior transportation program had about 40 volunteer drivers who are paid mileage to travel over 141,000 miles to take residents to medical and other appointments in 2011. Riders and others paid $6,950 in donations and fees toward the $68,113 expended to provide that service.

Public health screens people to provide appropriate home care services for skilled nursing; occupational, physical and speech therapy; home health aide services; respite care; and homemaking. In 2011, 651 people received these services, including 2,001 nursing visits, 173 therapy visits and 4,701 visits from a home health aide, homemaking aide or respite care.

The highest number of public health clients were in the 65 to 85 year old age group, but number of visits was highest for all people over age 65, including those age 86 and older. While the next highest age bracket for people served was age 19 to 40, the number of visits to those clients was far lower than for the older population.

Income Maintenance

Income maintenance cash, emergency, group residential housing and food assistance program use increased in 2011 by number of people and in cost.

During the month of December, 2010 payment to clients was $676,806. That increased to $760,880 in 2011.

Annual health care cost $57,103,585 in 2010 and $62,321,569 in 2011. Wolfe said those costs include the cost of nursing home care for some clients.

Child care assistance use dropped from 511 to 481 between 2010 and 2011. Costs dropped from $86,544 to $72,990.

There was a decline from 133 to 119 referrals for welfare fraud prevention, but a total of 54 negative cases was found in 2010 and in 2011, saving the county future benefits costs and overpayments.

Three cases of ineligible people already receiving benefits were referred to the county attorney for prosecution in 2011. Another nine received an administrative disqualification. Three made a repayment agreement. Three cases were unsubstantiated. Three cases could not be proved or the person was unable to understand. Two people involved in one case were ordered to make restitution and disqualified from food benefits for one year.

The fraud investigator has 12 pending cases.

Child collections workers collect court-ordered child support payments from non-custodial parents to pay to custodial parents whether or not parents receive benefits. There were 1,791 child support cases in 2010 and 1,797 in 2011. Payments collected for children’s care increased from $2,711,547.36 to $2,815,526.63.

There were 123 default orders the court issued in 2011, down 10 from 2010.


Cass HHVS received $13,600,939 revenue in 2011. Of that $6,033,320 came from the local property tax levy. The balance was paid mainly from state and federal programs.

HHVS financial division processed 42,035 transactions in 2011 and reported to proper authorities. State officials have repeatedly cited Cass for total compliance with reporting requirements.

Veterans Services

The veterans services officer has an office at HHVS building in Walker. The veterans benefit specialist has an office in the land department building in Backus.

Satellite office hours are held periodically in Remer, Pine River, Pillager and Cass Lake, with the 507 veterans coming to the Pine River site by far the highest number.

Veterans services helps vets connect with veteran income support and medical care programs.

They also provide a veterans transportation service with volunteer drivers to take vets to medical services. In 2011, 214 riders traveled 53,725 miles in this program. Minnesota awarded Cass a $74,237.79 grant for dental, optical, special needs and subsistence programs in 2011.