I would like to call to order today's health and community service committee meeting.

It is Tuesday, February 3rd at 8:30 2 in the morning.

In addition to being able to attend in-person remote attendance has been made available to the public via Zoom at the link on the agenda.

This meeting is being recorded through Zoom.

I do not believe we have any members that are planning to attend remotely.

Is that okay?

Right.

All right.

So I will move on from that and move to our regular agenda.

Item number two is a pledge of allegiance.

If I could have member Dan Forth help lead us in the pledge.

Pledge of allegiance to the flag of the United States.

And to the republic for which it stands one nation under God.

With liberty and justice for all.

Thank you.

All right.

Can I have a roll call of members, please?

Yes.

Chair Altenberg?

Here.

Member Kasman.

Member Cunningham.

Member Dan Forth.

Member Kinesnik.

Member Main.

Chair Park.

Here.

Believe we do have a quorum.

Is there any agenda addenda to the today's agenda?

No addenda to the agenda.

Do we have any public comment?

No public comment.

Chair's remarks.

Nothing major, just welcoming everyone to February.

Man, what a what a month.

January seemed to go on forever.

And not a great way this year.

Um so just excited to uh get into this this agenda.

And I'm really excited about a couple of the items that we're going to be discussing about today.

Uh, do we have any unfinished business?

No units.

Well, welcome member Frank also here today.

All right.

Uh new business.

Uh item number one is a consent agenda.

Um it is to approve our minutes from December 2nd.

Can I have a motion?

Motion by Member Altenburg, second by member Kasmin.

All those in favor say aye.

Aye.

Any opposed?

The motion passes.

We'll now move to our regular agenda and welcome Dominic Strezzo, our uh community development director.

Welcome, Dominic.

8.2 is a joint resolution approving an emergency appropriation in the amount of $10,768.14 cents for the completion of an environmental review record.

Can I have a motion?

Motion.

Motion by Altonberg, second by member Maine.

Welcome, Dominic.

Good morning, committee.

Um, this appropriation appropriates dollars that we've collected through a series of agreements that we have with different agencies in the community.

We can uh complete environmental review records for entities that can't perform that duty, and they agree to compensate us for the staff time that it costs to uh do that.

These dollars come from, I believe two different entities like County Housing Authority and the Jewish Community Centers of Chicago.

And they just offset the cost of staff time to complete that report.

Fairly straightforward.

We see these fairly often.

Member Kasman.

Okay.

Oh, oh, sorry.

Yeah, did Member Alton?

No.

All right.

Seeing no questions, all those in favor say aye.

Aye.

Any motion or any of any opposed?

Motion passes.

We'll now move to item 8.3, which is a joint resolution accepting the emergency solutions grant from Illinois Department of Human Services and authorizing an emergency appropriation in the amount of $4,069 for grant administration and management of the homeless management information system.

Can I have a motion?

Motion by Vice Chair Altenberg, second by member Kasmin.

Dominic.

So this is a grant.

Uh it's actually federal dollars that pass through the state that we receive.

HMIS is our homeless management information system.

Um, but ultimately these dollars also offset staff time.

We have a staff member dedicated to managing the HMIS software, and these dollars will go toward uh her salary.

Excellent.

Any questions from the committee?

Member Maine.

Thank you.

I was just wondering, and I know this happens in this area a lot.

You know, budgetarily, since this was after this, are other funds being shifted, or is there additional funds?

Because we had planned to pay for this anyway, right?

Correct.

So what happens with the funds that were allocated that were going to be spent on this?

These were these this was planned for.

We didn't know this was coming.

Um we were a little late in the appropriation, if anything.

So we were you did know that this grant was coming.

Um, and we did plan for it in terms of her salary cost.

That helps.

That helps that well it the bullet says that not appropriated because the grant resources were secured after the county's adoption of the fiscal 2026 budget.

The execution of the grant agreement was what we're going to late with uh we emergency solutions grant is one that we received year after year after year.

So we did uh account plan for the monies to come in we were late in executing the agreement um with the state until after the fiscal year I I'll leave it be so I I guess that what I'm hearing is that we hadn't we assumed this was in the budget for the fiscal year but we just got the dollars after but you had to account for it some way in that budget right did we account for it as a I believe so in the personnel cost um do you understand what I'm asking we accounted for it and now we got this other money fantastic but we already had that money we had the money over here what happens to that money that we had over here that was going to pay for this otherwise I think what I think what I'm hearing is that other money was expecting that this was going to be that money.

Okay.

That's what I'm kind of hearing.

I need other questions from the committee all those in favor say aye.

Aye aye any opposed the motion passes all right this is what I'm excited to hear about.

8.4 is a joint resolution approving emergency appropriation of two million for fiscal year 2026 and accepting funding from the Illinois Department of Commerce and Economic Opportunity also known as DCEO Healthy Houses program.

Can I have a motion motion by member Kasman second by member Genesnik this is a grant we applied for about a year ago uh toward the end of 2024 we were notified we were awarded uh these dollars a couple months after it's taken us quite a while to uh negotiate and get to a grant agreement with DCEO but we finally done that um two million dollars all but 5000 will be passed through on to the community um private land or private landlords who will be doing eligible HVAC improvements to affordable rental properties throughout Lake County can get reimbursed through this program we're hoping to open up the window here by the end of the month and this will appropriate those dollars to help us reimburse private landlords up to eligible properties include up to six units per property and eighty percent AMI is the income threshold to be the clientele to be eligible so just so just so I understand this will this will support landlords that have designated units for those that are making under what percent of the median income under 80% 80% area median income um don't have to be any special designation they just have to prove that the cli uh the rental tenants are below that income threshold okay and they complete HVAC improvements and then we would reimburse them so that's pretty exciting and so do we think that so I have two questions one is do we think that this will encourage more to consider participating in lower income I'm hope so I I think it helps it'll help some of the deferred maintenance that often includes not just in affordable rentals but in rental properties in general so just improving the existing rental stack is helpful um I don't know that it would incentivize necessarily taking you know uh taking different types of clientele but it would certainly improve the existing conditions for those that are already in there and do we need to uh increase awareness of this and because is there is there a limitation on the timing for this yes the timing is tight and our plan is to open up an application window bringing as many applications as we can get prioritize those based on need age of the system the type of clientele in there um but also readiness because we do have until like June of 2027 to spend all the money right that's a lot to get done um so we are going to prioritize readiness of the units as well and that that really is gonna probably mean the income qualification piece that is going to be the toughest part for a landlord that's not otherwise dealing with rental subsidy is getting income documentation from your tenant um those who have that will probably be prioritized because we can get to those projects first.

I mean, I I'd encourage um also leaning on the members too to work with their municipalities and and reaching out directly to city administrators, housing, you know, leaders within the community, et cetera, to to get get this going.

Because it's just the short window, right?

We have for it.

There's uh there's a landlord work group that uh Lake County Coalition for the Homeless uh oversees, and we've already talked with them about getting on their agenda for a meeting in February to letting all those private landlords know about this as well.

Okay.

Excellent.

Any questions from the committee?

No.

Yeah, member Kazna, please.

Thank you.

Um is this precedented before?

I mean, have we got taken this route to try and um update some of these structures before?

We've done it, we do a lot of rehab, like with our CDBG dollars um passed through.

This is a little different in a couple different ways, in that it was it's through the state, so applying to the state makes it a little different in us.

Um contracting, that kind of uh coming to an agreement with private landlords is a little non-traditional, not passing it through a nonprofit entity.

Um, but we've done that before, like with the rental assistance program.

We did uh so it's not totally unprecedented in terms of the setup, um, but it's not not our traditional uh model and where we would pass through a uh a nonprofit.

Is it okay if I follow?

Yeah, please.

Um so um you'll sort of be relying a little bit on some of that infrastructure that you build up through the rental assistance program.

That's that's great to see us.

Yes.

Yeah, certainly the application portal itself is one of the the software we used for that is what we're going to use again for this, and just the the know-how that a lot of lessons learned to their program will be tapped into.

Um will we be give uh sending on word through the housing lake uh coalition that we've that we've built as well?

Definitely I mean that network um will be tapped into for sure.

Okay, okay, thank you.

See no additional comments or questions.

All those in favor say aye.

Aye.

Aye.

Any opposed?

The motion passes.

All right.

Move on now to 8.5, which is a joint resolution approving the second amendment to the home American Rescue Plan, a program known as home ARP allocation plan.

Can I have a motion?

Okay.

Motion might be second by Vice Chair Altenberg.

Thank you.

So our home ARP allocation plan, um, home ARP was a funding source that came through the American Rescue Plan Act, came through HUD.

Um, it is the way I think about it, it's a combination of two of our traditional entitlement programs, our home dollars, which are used to construct housing, our emergency solution grant, which is used to uh serve homeless uh the homeless population.

These dollars were specifically designed to build housing for the homeless population.

Um it's pretty restrictive in terms of who you can serve and what you can do with it.

When we got these dollars, we went through an extensive um consultation, public process, needs assessment, determining what the needs of the county were for these type of dollars.

We came up with two priorities, a fixed site shelter and permanent supportive housing, the fixed site shelter, one of the fixed site shelters is under construction now.

Um this project is an allocation toward permanent supportive housing.

We haven't been able to create new supportive housing units here in Lake County in a while.

This project is a partnership between Pazlake County, Community Partners for Affordable Housing, and the Lake County Housing Authority.

It would allocate um the entirety of our home ARP allocation dollars toward this project.

It's I believe a 14 14.8 million dollar project in the village of Mundaline.

We would allocate about five of those dollars.

It is still contingent on getting um the bulk of the funding through the state's application.

They have application in right now under review with uh the state, and they need that to come through to make the project feasible.

Um but our allocation will certainly help um that application and the scoring with them as well.

Dominic, can I ask?

So just so I understand.

So once we would allocate five million or so towards this, then who would ultimately be the administrator or once it's complete and it's done and who how who would administer that then?

It's gonna be owned by community partners for affordable housing.

So SEPA will be the owner of the building.

And how many units would we ultimately hope to garner from that?

The total unit count is is 24.

Um, our investment about five million we will monitor um a proportional share.

So we'll a quarter of the units we'll say, or or a little bit more.

Um we'll be responsible for monitoring who's in their annual basis, their income levels and things like that.

But this type of development, there's gonna be subsidy in all 24 units.

So really we'll be monitoring all 24 um throughout the 20 year period of affordability on this project.

Okay.

I'm gonna get a little detailed here.

How many, how many uh what's the general occupancy of the 24 units?

Yep.

I've got so just bedroom count, I'll start that two one bedroom units, 16 two bedroom units, six three bedroom units, and uh the AM, they're all going to be below 60% AMI.

Okay.

Um 15 of those units will be below 30% of AMI.

And that's where our money will kind of plug into that because that is more or less the the folks coming off the coordinated entry list, the lowest income, and those are the support of housing units there.

Okay.

So multifamily generally looking to have two to three bedroom units.

Yes.

And the supportive element is crucial here as well.

So there'll be on site case management services.

Um it will look and feel from the outside like any normal apartment building, but the supportive element will kind of be baked into the um the clientele as well.

And and get again again, a little detailed here, but anything for senior level on this, would we have encouraged or or open or not contemplated?

There's nothing preventing seniors from pulling uh from getting in, but it's not age restricted.

Um I think well, there's only two one bedroom units.

Typically, those seniors can fit well with the one bedroom.

This one is I don't want to say oh got prioritized a little because of the three bedroom count.

It's rare for us to get multifamily with three three bedroom units in there, and having six out of the 24 is a little special in that sense.

So we're really working with families.

I mentioned that needs assessment when we went through the families on the coordinated entry list, are the hardest to find because there's just not the multi uh multi-bedroom units available.

So the the reason I ask is obviously we're we're aging population, right?

Um seniors having very old parents myself, just having wider hallways, accommodations of bathrooms, things like that.

So I would just encourage if we're going to do this, that lets let's know that our we could I think we should encourage older individuals and therefore we just need to modify how we produce our units, right?

To accommodate older, older people living on their own.

The accessibility, I mean accessibility features.

The accessibility features are mandated by the Ida design standards.

Um they're targeting folks with disabilities too.

Okay.

But like walk-in bathrooms and showers, like that, that alone dissuades seniors from having if you don't have a be able to shower, you can't use the unit.

Sure.

Yeah.

Okay.

Thank you.

Um question.

Um, Member Altenberg and then Member Kenisna.

So I'm wondering how many people are on waiting lists for this kind of housing.

Many.

It varies.

Um, but the coordinated entry list, I mean you're talking from 50 to 100 at any given time.

You know, there's monthly intake and an outflow of that list, but I mean, for a ballpark, I would say that.

Um, and some of them have been on for a very long time.

Yeah.

That's where the families kind of get stuck.

The need is great.

Yes.

So I'm just my question is very similar to Mara's.

It's just uh a little more focused narrowly.

Um, and I don't necessarily expect you to have the answer.

I'm just curious.

Uh so I'm wondering, you said a few moments ago that this project has the um six available three bedroom units.

And you said that's kind of special.

Uh and I'm assuming it's because it's hard for people with uh large families to be able to find this type of housing.

I'm just curious if through the housing lake process you have a sense yet of like how in order to satisfy the need um for units of that size, how many would we need generally speaking, a countywide?

I would if I was looking for a quantitative element, I would fall back on that 2023 study, and I I want to say it was I mean, order of magnitude, it was 6,000 six to 7,000 units.

Of that of three bedrooms or families.

They they characterize it as families.

Um that two bedrooms or two or up, two bedrooms or more.

I when I'm talking when I talk, I would say above two.

So three, yeah.

And so like six thousand to satisfy the yeah, that would be the demand to satisfy the okay.

Thank you.

Um, I want to congratulate the county board for making these investments in our and our housing.

Um, I really appreciate it.

And I just there's been a significant increase in families in need like this.

So I I'm really grateful.

I'm glad to see those larger units, even though it's harder.

It's it's definitely needed.

Um, I I can't vote for on this, but um, because I'm on the Pads Lake County board, and that would be a conflict of interest.

But I just want to thank you for your very diligent work.

Um, this is a lot.

Um, and I just want to thank you.

No problem.

Thank you.

Yeah, excellent.

Uh Altamberg.

Yeah, so I just want to say, you know, our housing lake um project that's been going on.

This illustrates, you know, why this is so important.

We are, you know, when you look at the report that came out from Lake County Partners, we are having a really big shortage of all kinds of affordable housing, all different price points.

And we need to keep reminding our municipal partners of the great need for them to be partnering with us and supporting the ideology behind this, and they need to spread positive ideology about those two their um municipalities to their constituents.

We've all got to be supporting the idea that we we absolutely must have more of all kinds of affordable housing in the county.

It's not a question of do we need it?

We have shown we absolutely need it, and we've really got to pull people on board with us.

And I think it's it's a whole thought process that we've really got to be encouraging around the county.

So I think Housing Lake is going to be continue to be a vital project and in getting those messages out.

Absolutely.

Thank you.

Chair Hart, you have a comment?

Thank you so much.

And I I had to step away for a moment.

So perhaps somebody asked this question.

But permanent supportive housing is what we uh with the federal government is cutting.

I think in at the previous meeting, it was it might hit some time.

I think it was April.

So what impact does that have on this project, if any?

It doesn't have a direct impact.

Uh so the shift away from the permanent supportive housing model is targeted at the continuum of care funding, the service dollars.

This project specifically, the their pro forma that they've designed is independent of those dollars.

So we we obviously took that into consideration when we decided to you know through the underwriting process of this project.

Um it is the type of project um and a model that at least under the initial notice of funding opportunity that some of the policy shifts from HUD that they wouldn't they don't tend to support.

But this project specifically can stand alone, regardless of if that COC funding was cut or not to exist.

Um we'd still be able to operate it.

And locally, um, our data that we've been collecting over you know a decade or more does show that the supportive housing model has produced successful outcomes.

And and that is, and I mentioned that needs assessment that we went through that was part of the process evaluating is this the type of project that we would want to allocate.

Um it's a significant investment, no question.

Perfect.

Thank you very much.

I just wanted to understand in terms of that continuum of care that you were talking about.

Um, but certainly I concur with everybody who spoke about the need for more affordable housing and in particular permanent supportive housing.

So thank you so much.

All right.

Seeing no additional questions, all those in favor say aye.

Aye.

Any opposed?

The motion passes.

All right.

We'll now move on to what am I on?

8.6.

Yes, 8.6.

Joint resolution approving the third amendment to the program year 2025, United States Department of Housing and Urban Development Annual Action Plan.

Can I have a motion?

Motion.

Motion by Altenburg, second by member.

Thank you.

So now we're shifting back to our traditional annual entitlement program, CWG Home and ESG.

This amendment makes four kind of reallocations that I'll go through.

The first one is with the city of Waukegan, their home dollars.

Initially, we had um funds allocated to their their own owner-occupied rehab program.

They were able to secure some other funding from the state, and they requested that we reallocate 120,000 from that program into a down payment assistance program that'll be administered by CEPA, um, specifically for um homeownership in the city of Waukegan.

The second change um requested is prioritized by spending.

So we have dollars allocated to a Lake Forest senior project with SEPA as well.

This project's been a little slow to get going.

It's bounced around a few different sites.

Um, and some of the dollars we have allocated go back to program year 2022, and we want to be proactive in terms of spending.

Um, we've talked to them, so we're hoping to reallocate those 2022 dollars into two different projects, both with SEPA.

One is a community land trust program, and the second is their EB Lee Senior Apartment Building in Libertyville.

That one's under construction.

Um they've had a few winter uh related change orders, so 200,000 would help support that ongoing project in Libertyville.

Um the third and fourth change are are coincide together.

We had a project with uh Liberty Arms.

So that's an apartment complex um in the southwest portion of the county.

Um they were supposed to do some roof repairs, they were able to secure again additional funding through the state.

Um so they don't aren't aren't in need of our 200,000 dollars.

We're requesting to pool those dollars together um to help with the the program we discussed earlier, the HVAC program.

Those dollars I mentioned are federal, so they're subject to an environmental review.

Part of that includes asbestos lead-based paint and radon, but the dollars from the state cannot go to any potential mitigation if those are found in any of the properties that we want to invest in.

So these these dollars would set up a pool for landlords to tap into for uh remediate environmental remediation on program properties participating in that HVAC program question from Emmeralton.

No, yeah after this question after this, okay.

Uh any questions on this.

All right.

All those in favor say aye.

Aye.

Any opposed?

The motion passes.

Yeah, Dominic, I had a question for you before you uh take flight.

Um so I'm wanted you to comment on this is the first year in several uh years of doing this that we have not been able to do our homeless count, our in-person homeless count.

And I wanted to talk about that for a minute.

And that was because of a lack of funding, or not necessarily a lack of funding.

Okay, it was it has to do with um as chairman, the the back and forth around the continuum of care funding.

And I think we will talk about that a little bit more um in the general discussion around federal dollars toward the end.

Um but HUD put out they changed kind of the rules uh for the continuum of care funding, which scrambled um Lake County Coalist for the homeless to react and then they pulled it back and then they put it back in.

So at the same time that we would have been planning, it does take a decent amount of uh staff, not only by community development, but the agencies themselves to prepare for and put out the point uh the point in time count.

And they were stretched pretty thin in terms of recreating an application around.

They run an internal application round, and in this case, they were they had to run it theoretical application around around total new set of rules that really they had to make some real tough choices about cutting programs, entire um program redesign to try and maximize any potential dollars that would have came into the county.

So it was decided by the coalition, they took a vote and they requested that the that component, the point in time, the unshantered count of the point in time not be completed this year because they the capacity was stretched a little thin.

Um so that was that was the main decision.

It came at request of the coalition for homeless.

We agreed.

Um things are still ongoing.

Um we have not been able to submit yet that application.

The lawsuit is still ongoing, and we'll get into that.

I give some updates on that later, but it was not a funding like a loss of funding, it was more the time commitment.

Okay, and do you expect this count to come back next year?

Yes.

So we do have to do it at least every other year.

This happened to be one of the years that we could have taken it off.

We've only we traditionally have done it every year, but you're only required to do it every other year.

Okay.

All right.

Thank you.

Remember Casman.

So the court sort of postpone the this decision by the federal government, right?

They for there's a temporary order for uh asking HUD to go through with renewals.

Um so that's current status.

They they are making steps for renewals.

Um that's that that would post that's relatively recent.

That's the current status.

Yeah, they're supposed to be there.

Has not been a final ruling that's due February 6th, hopefully.

And when changes like this that are fundamental and a significant shift away from permanent sportive housing.

When that what is the usual because this seems really abrupt?

It feels like um, if you're gonna make a change like that, you sort of um talk about it, then you'd help, you know all the organizations and agencies and governments like government layers um build a work plan to scaffold to though to those significant changes so that it's not as disruptive.

I mean, when was the last time we had a change like this?

And and how did it how did it roll out?

Exactly on the agenda.

Yeah, that's a good point.

We I mean I think I think the question is is does this normally fall under members' comments or questions, or I think I think the the I was I guess uh supportive of the initial conversation, but if we want to have an actual conversation of this, we probably do need to back at the end.

Come back.

And come back at the end.

Okay.

Sorry.

But if he's okay.

Well, maybe it's something to discuss that like there's a county and there's like an administrator report afterward, because he's I'm you're not gonna stay for the whole.

Okay.

I'll be well.

I brought it up because I didn't know if he would be here at the end.

Okay.

Okay.

Okay.

All right.

Thank you, Dominic.

All right.

We'll move now on to item 8.7, which is a joint resolution accepting the Illinois Department of Commerce and Economic Opportunity, D CEO, workforce innovation, and opportunity grant career planner, training academy grant, and authorizing emergency appropriation in the amount of 119,123 and five cents for the Lake County Workforce Development Department.

Can I have a motion?

Motion by Member Kasman, second by member Kenisnik.

Welcome, Director Sereno.

Good morning.

Um this is a new grant we're receiving to offset the cost of personnel cost associated with launching a new case management reporting and performance management system.

Um the lead trainer will be leading out the work, launching the new system with career planners in Lake County, McHenry County, and DuPage County will also be offsetting a small portion of another position to help project manage so that it stays on track.

Excellent.

Questions from the committee?

All right.

All those in favor say aye.

Aye.

Aye.

Any opposed?

The motion passes.

Thank you.

Thank you.

Thank you.

All right.

Well, welcome director Kritz and executive director Hoff for the next item, which is 8.8 as a joint resolution approving an emergency appropriation of 12,550 for fiscal for grant fiscal year 2026, accepting additional funding for the public health institute of metropolitan Chicago, pop affirming care and routine HIV screening development grant.

Can I have a motion?

Motion.

Motion by member Kinesnik, second by member, or yes, can easily second by member main.

Welcome.

What do you want me to say?

You have questions.

Yeah, this is additional money for an existing grant that we have for HIV population affirming care.

Uh it's in Lisa's area.

So we brought just in case there were additional questions, uh, just looking for appropriation for those additional grant dollars.

Okay.

Now we got questions on this.

Uh no.

I don't see any questions.

Just generally, how many total people are we looking to screw?

This will this will support our overall screening efforts, right?

Um yes, it's our screening efforts, uh, it's gonna be provided in our SAP, our substance abuse program.

And so how many generally, Lisa, people do we tend to get to screen for HIV?

How many people do you have an SAP?

Screen it could be a couple hundred.

A couple hundred.

So are these all the dollars that are used for the screening or or is this part of the part of the funding is also being used?

Oh, okay.

Um I'm trying to because it's split up.

Um part of the money is being used for um providing training on affirming care to SAP uh staff.

Yeah, uh member main.

Thank you.

Lisa, with this, uh, with these dollars, does this help us hit the 90, 90, 90 goal for HIV screening?

So I mean that's I think that's what we want to know.

Are we hitting the metrics?

And I know I've asked this other year's like where where do we think we are in our metrics?

How many people with HIV who are HIV positive in Lake County?

How many of them do we think know their status?

Uh I would have to get back to on that question.

But um Well, that's the point of hitting the 90.

Right.

I mean, right.

We think it's 90.

Do we think it's not?

And that we would need to know where we are, where we are on that metric.

Because I think that's the whole point of having the additional dollars that we're improving our metrics and hitting what are probably global standards for HIV and the diagnosis treatment and remission.

And the SIP clients are high risk.

The substance abuse program.

Yeah, the beauty of health governments program is for HIV testing because we're trying to bring behavior health, all of those behavior health, substance abuse, general medicine, women's health, like all of those into standardized HIV testing.

That doesn't happen in every health care provider home.

So we'll get the number and get back to you.

But yeah, super important because it's not integrated.

It's often like this separate testing thing that happens, you know, that year normal.

Yeah.

So I think that would be a good thing in a model of some standardization.

Because in those high risk populations.

We might not, right?

We might overall be hitting our 90, but we might not be hitting our 90 in certain high risk populations that are more likely to have behaviors that would spread the disease, sort of like a high spreader.

Okay.

90% of those that are.

So that whole is 99%.

90% of the people who are HIV positive know their status.

90% of those who have it are being treated, and then 90% are in remission.

So that's been a part.

Or undetectable.

Yeah.

Remission and undetectable.

But that's been a long standing goal now, international goal for a long time.

All right.

Any questions?

All those in favor say aye.

Aye.

Any opposed?

Motion passes.

Okay.

All right.

We'll move now to 8.9.

Was joint resolution approving emergency appropriation of 40, 26, 266 for grant fiscal year 2026, accepting additional funding for the Lake County Children's Advocacy Center victim victims of crime act grant.

Can I have a motion?

Motion by member knees, second by member Kasman.

Cas change.

Thanks, Michelle.

Yeah.

This one.

Uh Director of Behavioral Health, Michelle Lesser.

Hi, good morning.

So these funds continue the co-location of uh child and adolescent behavioral services program, bilingual senior therapist at the children's advocacy center.

So by being on site at the center, this therapist can provide immediate um intervention and then ongoing trauma treatment to the children and families who present at the center for a forensic interview.

Um and data for the past two years show that 79% of the children show a reduction in trauma symptoms as a result of these interventions and this therapist being on site.

We think it's a really great integration of service.

It's a great opportunity for the health department to work together with State's Attorney's Office, Child Advocacy Center, really excellent opportunity.

Good question.

So just on the on the the bilingual then.

So does this person support only bilingual or all just that they have a capacity to support those that are bilingual?

Yeah, okay.

Just the capacity to support Spanish speaking.

Um and do we have more multiple therapists on staff?

We have one therapist from the health department at CAC.

Okay.

So this one staff member is bilingual.

Yes.

Okay.

Okay.

Excellent.

Any other questions from committee?

All right.

All those in favor say aye.

Aye.

Any opposed?

The motion passes.

Okay.

Thank you.

All right.

Staff change.

Here we go.

Change.

Uh 8.10.

Joint resolution accepting a resolution approving an emergency appropriation of 75,980 for fiscal year 2026, accepting additional funding for the Chicago Department of Health Public Health.

Ryan White Part A grant.

Can I have a motion?

Motion.

Motion by Member Altenburg, second by member Casband.

Okay, now I get this.

Okay.

Um this is additional funding that we got.

Um, and we would like to use it for our MMC um uh clinic, which serves our HIV clients to buy uh vaccines, including Shingrix, HAPA, HEP B and HPV and meningitis, so that we can protect our most vulnerable.

So this is vaccines to support our HIV population.

Correct.

Okay.

Obviously non-HIV related, but for those that have HIV.

Correct.

Yeah, we're the medical home for people with HIV.

We manage a population of patients that have HIV and do all of their kind of wraparound care and services.

This funding helps to take care of that population.

How many, how many individuals?

Uh we have about uh 377 clients in MMC.

And they're they're entirely dependent on us for their general medical home.

Yep.

Okay.

Wow.

That's larger than I thought.

It's about 50% of the HIV population.

In the county.

In the county.

Wow.

What helps us get to that 9099 goal, right?

You can provide all that care, make sure they're undetectable, know their status, and provide all the wraparound care that helps prevent other infections that people with HIV are more at risk for.

And I'm assuming we also cover their HIV medications.

Yep.

All right.

Any questions from the committee?

Member Kasman.

I mean, it does this, is this model typically exist in other counties, or do they rely on partners, or how how does that usually work?

Yeah, the I mean the Ryan White system has been around for decades funding specialty care for HIV providers and patient populations.

Not every county manages that, not every county has primary care and that special.

Um but uh unique to Lake County.

Yeah, that's what makes us unique is that we have um the provider as well, plus the case management um aspect of it.

I think that's extraordinary work.

And I think um it could be I mean, it must be a strong prevention tool to keep the spread in Lake County.

And I I and you're able to keep such good metrics.

And we have 93% um percent suppression um with our clients.

That's incredible.

Yeah, yeah, I'm great work.

Proud for you about it.

Thanks.

Okay.

Any other questions?

All right, seeing none.

All those in favor say aye.

Aye.

Any opposed?

Motion passes.

We'll now move on to the last item before the commit uh county administrators report 8.11 is a joint resolution approving an emergency appropriation of 147,000, 152 for fiscal year 2025, accepting additional funding for the AIDS Foundation of Chicago Ryan White Act Part A grant.

Can I have a motion?

Motion by member Maine, second by member Caspin.

Um, this is a continuation of what I've brought here before, which is taking over for Catholic charities when they went out of the business of taking care of um HIV clients.

And so we have three staff on this, two medical case managers and one um non-medical case manager.

Can I can I just ask a general question?

Um obviously for many patients with HIV, it's it's a lot lifelong disease, but many over the year with the medications have started to do it's more chronic than it is, right?

Um so do a lot of our patients under care live like are they working?

Are they generally yeah, yeah, yeah.

Right.

So I guess the question I have is if they're they're generally working, they're under care.

Do they're insurance do we only cover those that were their work insurance is not covering their medications, right?

So we we we accept um insurance.

Right.

So so those that we're paying for tend to be just lower income.

Is that correct?

Right.

So they're just either not working or uninsured, or uninsured.

Okay.

Excellent.

That's what I assumed.

I just wanted to just clarify that.

Because most I would be, you know, it's we're working, like they're some people come just because we have really good care and um, you know, a very caring staff.

Uh okay.

So their insurance, we are their pri there we we take their insurance.

We're their primary care, just given that they've had continuity of care with us.

Yep.

Yeah, all of our programs try to have sliding fee scale for those that can't afford it.

Medicaid, we build commercial where we can, make sure we have sustainability for those programs.

Yeah.

Um member Frank.

Thank you, Chair.

Yeah.

I really appreciate the fact that you asked questions.

Is that there is a fiscal time op for us because the implications of federal policy changes.

We're going to see a dramatic number of our clients lose their Medicaid coverage, which does reimburse the health department.

If you're on Medicaid, it's your insurance.

And that pays the health department for services that people are seeking.

Yeah.

It's not going to cause people to stop seeking services.

They're just going to come in without coverage.

And that's uncompensated care and many types of services we do not turn people away for, but we will eat the cost of that.

So this brings up a whole host of additional questions that we probably need to think about in the in the future.

Um, and I don't know if we're going to cover some of those in this next discussion or not, but um clearly we'd like to talk more about it as member Frank and in addition to that is the question of how the federal government is gonna fund HIV services.

I think in addition to that is the question of how the federal government is going to fund HIV services.

Right.

We really don't have an indication of that.

Um, a lot of important questions we need to tackle, but I think we will we'll cover on this item and then move on here.

Are there any more questions on this one?

Seeing none, all those in favor say aye.

Aye.

Any opposed?

Motion passes.

Thank you.

Thank you.

We'll now move to item 8.12, which is an update regarding status of federal funding in county departments.

Good morning.

Patrice Sutton, County Administrator.

So over the last several months, um, you've heard from staff that we are monitoring the federal funding uncertainty.

And I've had a lot of uh follow-up from county board members asking, what are you doing and what's the plan?

And so I wanted to let you know what we've been doing to date and get your feedback on our way forward.

So staff have been working together to gather data regarding federally funded grant programs.

The programs most impacted are the ones that you've heard from today, the health department, workforce development, and community development.

We, of course, do have federal grants in other departments as well, but we're starting with these because they have um they're directly involved in health and human services and might have a direct negative impact on residents, clients, andor patients, such as the loss of housing, access to medical care, or job training.

So, just with this preliminary research, you know, with these three departments, our staff has identified 26.9 million dollars that is at risk of 36.5 million of current awards.

So we've analyzed the current awards that we have in place right now, and we believe that 26.9 million of that could be um ended at at any time.

As you well know and have heard from our staff, the situation is very fluid and complicated with decisions being made and then often being reversed and/or legally challenged.

And so this is you know, a very fluid environment, and therefore coming up with a strategy has to acknowledge that fluidity.

Um for this reason, we've been working collaboratively to come up with a process that we can put into place to try to evaluate loss of funding situations in a way that mitigates the impact on our customers, clients andor patients, as well as the employees that work on these grant funding grant funded programs.

The goal of this process, where possible, is number one to ensure continuity of our programs and the service to our customers, clients and patients, and secondly, to provide peace of mind to our grant funded staff.

When staff leadership are notified of cuts, they act quickly to address the termination of services, and if applicable, the staff that provide those services.

Our budget policies indicate that if grant funding goes away and there is no other funding source, staff must be terminated.

Our work to date indicates that the most immediate and necessary need is to create additional time upon an announcement of the loss of loss of federal funding to determine a mitigation plan in the event that Lake County does not want to stop providing the program or service.

In other words, rather than having to cease services immediately, the county could cover a short-term continuation while the department tries to find other funding sources, or if none can come to the county board to discuss the use of contingency funds or reserves.

Allow time to assess the transition of their clients, patients, or customers, and provide time to seek alternate funding or determine whether ending the program is the best alternative.

A 60-day safety net for all of these programs at risk totals 4.3 million dollars.

60 days allows leadership the time to see whether the decision will be reversed and/or legally challenged, and to determine a logical and orderly path forward, informed by the county board's wishes.

Obviously, their need to react very, very quickly does not allow them time to get through our committee process and come and discuss the situation with you.

So staff is currently assessing each of these programs on a prioritization scale, assessing the life-saving or crisis care nature of the program, the population served, the county's mandate to provide the services, and or the strength of alignment with the health goals in our strategic plan.

We're also assessing the programs from a risk perspective, including the likelihood of cuts or delays, exposure to litigation and regulatory risk, and the operational resilience of the program.

If there are other programs or providers that can provide the service, these factors will help to best determine possible solutions, ensuring that limited funding goes to the programs with the highest need.

So at this time, um obviously I do have all the directors.

We've asked them to stay.

And I know that this is a conversation that you started to delve into earlier.

Um but what we're trying to do here is figure out a pathway so that those directors who you can hear from shortly have some additional time to deal with um programs that are ended, um, you know, not at the end of their term and or not renewed as they usually have been in the past.

So we are asking for this committee's direction regarding next steps in this initiative.

One request is whether there is concurrence that the budget policy, the states that employees who grants whose grant funding goes away are immediately terminated, can be loosened somewhat to allow for a safety net period due to federal funding uncertainty.

We really believe that the intent behind that budget policy is to ensure that if a grant ends and there's no future funding, that is really what we meant uh with that budget policy, not necessarily when a program is ended kind of uh suddenly.

And secondly, we're curious to hear whether this committee is supportive of an emergency appropriation for safety net funding from either contingency or fund balance or on to be used on an as needed basis to provide time for departments to identify solutions and inform the county boards.

So if so, we will continue working on a solution and share more information about that plan.

Um, but as you can, I'm sure you can understand the directors you're about to hear from are just looking for solutions to you know assist in kind of best mitigating this very um turbulent time when things can be very suddenly ended and they don't have much time to act.

Um, so we do have experts, obviously, that you've already heard from today from health workforce and community development.

They can provide more specificity about what they're seeing in their departments, um, and then we can open it up to your questions, get your feedback, unless uh you'd like to go in a different order.

So, I mean, I have a number of questions, but um I know others do too.

So let me let me take some questions from the committee and then and then I'll go into mine.

I know member Maine had a question, and then we'll go to Member Altenberg, then Casman, you had a question.

Or no.

Okay, and then I have just a number of questions.

Okay.

Um, I might have more than one, but I won't do all of them.

Uh, thank you very much.

And not surprisingly, you've come up with a very comprehensive plan that's looking at a lot of different ideas.

Um, I'll jump ahead to one point, what you said about the um grant funded.

I agree with your assessment that that policy, which I think is an important one, but the I I do believe the intent behind that policy was hey, this grant is going away, it's never coming back.

We need to move off.

So I would agree with that.

I do have an overarching question though in terms of the safety net and things like that.

And perhaps your overall approach, are you going to ask a couple of questions in a row here?

Well, I'll ask one later.

Are you going to every committee and laying this out?

This, what you just laid out to us.

Were you just coming here?

Okay.

HCS and FA.

Okay.

So my question is.

It seems like we're taking these and jockeying them.

Whereas to me, it's part of a bigger picture.

Because what this gets to the heart of is what are our overall goals?

And it could be that these are high, could be, these are higher priorities than other places in the county.

And that we would say, you know what, we would want to do an adjustment.

Yeah, this was this was a great idea over here when we had a lot of money and we were getting money from other sources.

That's not happening now.

And really, if we look at our overall priorities as a county, this one over here is higher.

And we want to make sure that that's at 100%.

So that's why I asked that first question.

Because it seems to me that we should not be these are all great question ideas and everything.

But by looking at them, well, I guess you're going to F and A and F and A, I can bring it up on Thursday.

Um, but that I don't think that we should be looking at these ones.

I think we need to say, and we kind of talked about it at the budget before of hey, what are all your priorities going to be?

So that's my that's my concern is that um, you know, are we setting up kind of a hunger game situation here?

Like there's only one winner in these groups when maybe there should be two winners winners or three, and there's other places where we've put money that are good, but overall in Mazl Mavwalf's hierarchy of needs, these other things over here are not as high.

And that's where the money should come from.

So those are my that was my, I guess, one question and then my thoughts.

Thank you.

Member Altler.

So, Member Maine, you you really got to the heart of the matter that I wanted to talk about too is priorities.

I think one of the reasons that Patrice is here at this committee first is because this committee is dealing with the human condition.

We're dealing with human needs, not every other department is necessary, you know, uh, that's gonna really affect people.

If we waited on a road and built it a couple years later, uh, people are not gonna die from that.

But um, probably.

But um I think for me, I feel like the county really needs to take uh to heart that we've got to help people with their health, with their housing, with their food.

Um, we've got to be able to take care of people.

And that's number one to me over a lot of other priorities.

And um, there's a lot of people in the county looking to us, they have no other place to go to get these needs taken care of.

And you know, I feel that that we definitely need to think about that as a priority.

Helping how how do we best help the people?

What, you know, and rank the priorities in that in that fashion.

I think it's important.

I think Patrice, you and your staff are thinking about that at this moment.

And the other thing we need to think about is every hour of the day, they're threatening to take some money, and then the next day we're suing to get the money back.

And there's a whole continuum with that.

So even though they're threatening to take the money away, it seems like it's taking a while back and forth before the money will go away.

And then we're trying to gauge how long we can survive with you know, how long is this money going to be coming?

We're not sure.

And it's really kind of an unfair crazy process.

They're putting people in very difficult circumstances because this government can't make up its mind about a lot of things.

And then there's the pushback, and we're pushing back.

Thank God the courts are sympathetic to people's needs.

But how long is that gonna last?

We don't know.

And um, I do think you're on the right track though, having this um safety net fund.

And because some of this, even though it says they say it's going away a certain fund, it may not.

And let's get it, let's give it a little time before, you know, we don't want to just take a leap right away, and then we we didn't lose the money.

So we want to keep the staff that we have because it's not easy to find that staff.

And um, so we need we're we're you're on the right road here, making some plans, trying to figure out how we can be in the best position possible to deal with these unusual circumstances.

Um thank you.

If I may, I was just gonna add that we are aware of all of the federally funded grants that are out there.

The reason we were starting um with these three departments, um, first of all, the health department obviously provides critical care.

And so, you know, obviously, unfortunately, they've been in the situation where they've had to send out termination notices to their employees.

And so, you know, they're the ones that are living this on a daily basis.

Um, and so we started with them so that they could help us craft the right strategy and plan um community development and workforce development are nearly 100% funded by federal funding.

So we did start with those.

We will definitely fold in the rest of the federal programs that we know of.

Um, and then, you know, to your point, um we want to be really careful that we don't come to you and exhaust the funds with things that are a liar lower priority.

Uh not that all of these programs aren't wonderful programs, but you know, we've come up with a methodology that is obviously uh there's no methodology that would ever be perfect, but we're trying to prioritize these and make sure that we would come forward with the ones that um are scoring the highest on the prioritization and the risk uh scale that we're trying to put together to um make sure that we're kind of bringing forward the ones that are the most urgent and critical.

I just I have a let me just go through a couple of comments and then I'll have the committee.

So can Patrice, correct me if I'm wrong, but I kind of see it in just simplicity in kind of three buckets.

One is Congress funded administration not funding, right?

And so those are kind of and then getting challenged.

Then there's administration policy directives that cannot maybe be challenged that are ending things, right?

And then there's things that are in law now, like changes to the health care uh to the Obama subsidies, right?

That will increase likely the number of people then who do need to fall into care.

Um, just given their economic situation.

There's probably other things I'm not thinking about.

But those are those are three different kinds of situations, right?

The first one's getting challenged a lot.

So those fundings may come back.

There's policy changes that will happen, likely.

And then the third one are likely to happen too, just because they're in law now.

So are we gonna prioritize potentially based on the level of certainty of the cuts then?

Is that my generally following how we're thinking about it?

Yeah.

That is what we're attempting to do, as you can imagine.

Um the team is this is a really hard scoring exercise.

But yeah, we are trying to take that into account and make sure that we don't come to you and ask for contingency on something when a worse shoe falls, you know, uh three weeks later and we've already exhausted the funding.

So yeah, that is the exercise that we're trying to do behind the scenes.

So my my general thoughts are, and I I liked what um Member Maine said, and I like what Member Altenberg said.

I would just say that that's a great exercise for maybe next year, but this year, given just the we don't know enough that I would feel more comfortable putting aside a fund to assume kind of the worst-case scenarios and not letting anyone go by without the care that we anticipated going into 26 and utilizing the funds we can without disturbing the other departments and looking at our, and you know I've been advocating like going into our reserves.

I think our reserves are too high.

I would appreciate I always thought about it as capital investment, but human needs are capital investment, right?

And so utilizing our existing funding structure to make sure that we're funding at capacity, the things that we plan to do when we made our policy and budget choices last year for 26.

That's that's my general thinking.

Does that make sense?

I do, I understand what you're saying.

I think um, you know, part of the complexity here too is that we're not sure it's going away.

I mean, even the continuum of care thing that you've heard Dominic talk about a lot is not completely taken away, but it is already impacting how um participants in that program are behaving because they don't have that certainty.

So, you know, I think part of the complexity is that it will take a fair amount of money uh to kind of shore up those programs when it may be found that it's not needed because it's the uncertainty that's already impacting the program.

So that's really what we're struggling with is how to solve for those problems because we may not need to bail out an entire program, but yet it is disrupting um how things are you know going in that program.

Is that fair to say?

Yes.

So I I think that's what we're trying to um figure out a way to handle.

Um I guess in my my one person of 19 opinion, we have the reserves, use them, okay, feel comfortable using them.

And then if we don't use them, well, they go back into our reserve.

But we have, I think, ample reserves.

Uh this we always say we have reserves in situations of risk and high uncertainty and need.

And I think this kind of a Venn diagrams, a lot of that stuff to me that we have it.

Let's not make people feel that their care is going to be cut off and utilize.

And if we don't, we can always just put it back into our reserve.

You know, we have it's just moving from fund to fund in essence, right?

Until we utilize those funds.

So I I would say let's not worry about it and let's do what we need to do.

And then we can reassess in 27 for 27's budget.

That's just my opinion.

I'm one of yeah, it cannot be understated, you know, the impact of the uncertainty on the patients or clients, as well as the employees that work on on these programs.

And I'm and I'm thinking of both as I was kind of making my comments.

Um member Kasman, member uh Dan Forth.

Um yeah, I agree.

I I appreciated all the thoughtful comments of of all of you.

Um I think emergency reserves are for emergencies.

This is a kind of a strange sort of emergency, but I it is an emergency that will have a life in death, could have a life and death impact on a number of people, our most vulnerable residents.

So I really appreciate um the structure of the methodology you're trying to bring to what is a chaotic and and and dynamic situation.

Um, but yeah, I'm I'm all in favor.

Thanks.

Member Danforth.

Thank you, Gary.

Um questions.

I mean, I think we gotta be careful when we talk about re funding on reserves because it's depending on the length of the impact of potential cuts, um, we wind up potentially long term funding something out of reserves, which is not a good model to have.

My my question is is how many dollars are we talking about potentially that are at risk of not being funded?

And if we do go with a plan of reserves or whatnot, how does that potentially have a negative impact on our fund rate?

Yeah, the point is valid.

Um 26.9 million dollars has been identified just by these three departments as um funding that is um federally funded that could um be at risk.

Obviously, we could go into reserves on a short-term basis, but that's not a long-term operational solution.

So it would just be, and and I do want to reiterate that what I'm stating here is just giving us enough time to figure out what that long-term solution in is, and it may be that we can only sustain the program long enough to transition the clients or the patients or the customers out of it.

So, you know, so that they at least have a little bit more of a lead time, or we may be able to find long-term um funding.

But you're absolutely right, this would have to be a short-term solution that just buys us time to work on the longer solution for sure.

Is there a potential negative impact using reserves or these types of emergency situations impacting our credit worthiness?

Yeah, I think um we have a fund balance policy that does state um, you know, these are the types of things that you would dip into the reserve for before you can utilize the reserve.

You do have to weigh, you have to come up with a plan though to um replenish that reserve.

And so that would be part of the plan.

As long as we do have a plan to replenish the reserve after a valid use of the emergency reserves, I think that the bond rating agencies would be fine with it because that is the intent.

Um, with you know, lacking a replenishment policy or or plan and perhaps, you know, dipping into the reserve for the ongoing costs, that could cause us a problem.

Jared, if I can.

I mean, when I hear that type of conversation, what I'm thinking about flashing red lights is oh, we're going to have to have a levy increase.

You know, I mean, that's yeah.

That's what I'm hearing.

Is that that I mean, that is maybe the depending on how you look at it.

Your worst case scenario is that if you really wanted to fund this and it had to get done, you're gonna have to raise it.

I I guess I I would just question that's a good question to uh member Dan Forth.

I would just say personally, what is the percent we have today?

And is that does that need to be at that percent to still mean the triple A bond rating?

Right.

You know, I think we have maybe 187 million in reserves.

I think we should probably go to to the the people that rate ours and say at what level are we acceptable?

Do we need to stay at 187?

Can it be where's the bill safe?

Right, where's where's the amount that we still maintain and could it be 150, for example, and that we could get back to that one?

Frankly, we probably don't even need to get to 150, but let's say we do is that we then say, okay, we might need to increase the levy a minute amount over the next 10 years or whatever, like very little to get back to where we are.

Like build back the reserves, yeah, to build back the reserves.

But I would hope we can have that conversation at some point in the future, then.

But I personally think they're too high.

So uh, member Casbin, Member Kinesnik, Member Maine.

Yeah, I I know there are some counties in um in the country that have done, you know, sort of a study to show historically what is the lowest was what is the most we've ever had to draw on our reserves um in the past, and they've come up with a recommended reserves level based on that.

Um, so they actually use like research and data to inform, you know, how much reserves, and I know we do that too.

I'm not saying, but um just but it would help us see like what is the actual number that we need to have in reserves.

And I I like the idea of having that conversation because it maybe end up being that we we are at the right.

And that's and just and I don't want to dissuade any more conversation, but that's probably an FA conversation that we'll need to have at some point as well.

Uh member Kinesnik.

Thank you.

Uh I agree completely.

We should, as we make these decisions going forward, we mean need to prioritize a plan to replenish those reserves.

I couldn't agree more with uh Member Dan Ford that the worst case scenarios to have to um increase the levy in order to get back to sort of that ideal number of reserves.

But before we go any further, and especially before we get into discussing in detail um the types of programs and services that are life-saving and at risk, I just would like us to remember and be sure to state unequivocally for the record that this period that we're looking at, this period of chaos and uncertainty has been inflicted by the policies of the federal government.

And so I don't want it to get lost.

Um we are debate about to debate these very difficult questions um because of uh a situation that did not have to be inflicted, but has been inflicted upon us.

Uh and I just like to everyone to keep that in mind as we move forward.

And um please let's all keep repeating that out loud so that um and and clearly for the public record, so that we know where these challenges originated from.

And let's not forget where they came from.

Thanks.

Thank you, Member Kenesnik.

Uh member main and then member and then Chair Hart.

Um and to the chair's point, this might be more of an FA.

I think I recall, just to follow up on member um Dan Forth's point, is doesn't the health health department have its own levy?

It does.

Yeah.

So I I'm not sure everyone realizes that that the health department actually does have its own levy, and that goes to the point it gets folded in to the overall levy.

So you know, it goes back to priorities, and maybe there are other things that are less of a priority and a levy.

You could keep the overall tax levy the same, but have more of the levy from the health department dollars.

Yes.

I I just want to put that that out there.

So there are direct ways for us to fund.

And it was put there long ago before there were other resources.

So there are other ways to I won't say skin the cat, because I have a cat now.

I have a cat now, so I can't say that.

But anyway, there's other ways to get there.

Thank you, Member Maine, for that reminder.

Member uh Chair Hart.

Thank you very much.

I appreciate this discussion.

Also was just gonna say, yeah, all this reserve policy, you know, should happen at FNA, so thank you for that catch.

Uh, I just want to make sure that I understood um, Patrice, you had said that you've got your departments there.

Were you hoping that the department like I'd be interested in hearing from the departments if that's what you had designed uh for today's meeting?

But I would be certainly in favor of identifying or for staff to identify what are those programs uh that we really want to continue.

Um, and then for that timing, right?

So you you talked a little bit uh, or excuse me, Chris Hoff mentioned having to let go of employees, and then within what 24, 36 hours, it was like, oh, sorry, just kidding, right?

So now what do you have to do?

Like restart payroll, how does that work?

So that's a real problem.

So I am absolutely in favor of uh making a change to those finance policies uh to ensure those kind of things won't happen again.

Thank you.

Yeah, I had to ask each of the directors to make brief remarks about their current situation if you'd like to hear that.

Um that kind of formulated the um the process that we're going through.

I would love to hear that.

Thank you.

We were gonna start with Chris Hoff from the health department.

You could you could set you.

All right, good morning, everybody.

Uh, thank you for the time to have this conversation.

And I want to acknowledge Patrice and Matt's efforts to bring some structure to it.

This is chaotic.

Um, since March, my first month on the job, we found out the health and human services agency at the federal government had cut 11 billion dollars in public health funding overnight.

And the contracts were eliminated as of the night before.

Member Kasmin, you asked a question about, you know, shouldn't we have notice?

Shouldn't this be communicated?

Yeah.

Yes.

It has not been.

And the reality has been you're going to bed scrolling and you find a news article that says, oh, the federal administration has canceled all of SAMHSA's grants, $2 billion across the country, eliminated as of yesterday.

We got that grant notice.

We had been going through the process to notify those employees who were covered by the grant that their jobs were going to be eliminated in 30 days pursuant to the budget policy.

We all live under that.

Um we want to be fair to those employees and follow that.

But this situation I don't think aligns with the budget policy as we've been designed.

So I'm fully supportive.

And you know, we talked about the opportunity to buy a little bit of time for us to evaluate the impacts of these changes.

Um, in some cases, you've seen in 24 hours they've reversed course.

Um that was the case two weeks ago with the SAMHSA grants.

We got an official notice that says your grants terminated.

24 hours later, I'm going to bed and I see, oh, never mind, it's restored.

And the next morning we get an official notice that it's restored.

That's one scenario.

Two is that immediately, you know, it's challenged in court.

And the Illinois Attorney General has been very active in pushing back against cuts to um grants to the state of Illinois and some of those grants that we have.

That process takes time, but very quickly it's heard by a judge, there's formal steps and there's a temporary restraining order in effect.

And that's, you know, sort of been going on indefinitely from March of last year for some of these grants.

So the opportunity for us to have 60 days to figure out is this real?

Is it permanent?

Are there other options to transition clients and staff to other programs and make a plan going forward would be extremely beneficial?

We have 27 grant programs that have some amount of federal dollars at the health department.

That's about 12 million dollars in budget.

It's incredibly disruptive to try to reorganize your budget, your staff, your client service delivery overnight when you learn about these cuts.

Um the last thing I would say is that I it would be much easier if we knew all of these were at risk and we could say, okay, let's pick the top three that we want to save.

We're not finding out like that.

We're finding out today it's this grant, tomorrow it's this one, two weeks later that's this other grant.

We've heard a number of our grants be sort of challenged um over the year in all three of the buckets you mentioned.

And so the logical process, like you want to impose some sort of logical model to this, it's chaotic.

And I think it's chaotic by nature.

Um, but buying us, you know, 60 days to figure out will this be overturned?

Are there alternative ways to provide these services?

Give our staff some peace of mind, right?

If you're a staff, we've had staff in one particular program that have been notified twice now over the past year that their jobs will be eliminated.

If I'm in that position, I don't feel like this is a place that I want to be long term and through no fault of our own, um, that's imposed on us by an external force, but I'd love to be able to give those staff some peace of mind to say, we got you for at least a period of time.

And more importantly, for the clients who read the news and think, oh my God, is my HIV care going to be eliminated?

Is my crisis services for behavior health not going to be available the next time I need it?

So thank you for the time to have this discussion.

Happy to answer questions.

Um, but more than anything, I think the opportunity to put some dollars and timelines to this is going to be extremely helpful.

Member Altmer.

Thanks, Chris.

Yeah, we we can appreciate you're in a very delicate, difficult situation.

And it's it's it's not gonna get any better.

Um so I was wondering, so you also get state grants, and are those also coming from federal funds?

It depends.

So we have a mix of grants at the health department that are either fully federally funded, 100%, a mix of state and federal funding, or just state or foundation or other things.

The state blends that federal money into a lot of different programs.

And we can track that out, but it takes a minute to figure out how much of this is federal, how much is not.

Um so some state grads are impacted immediately because they have federal dollars included in that subgrant to us.

So if we look at your overall budget that includes any part of a state or federal grant, what percentage of your budget is that?

About a quarter is made up of grants.

25%.

Okay.

So it's set.

12 million is federal money.

So 12 million of 25-ish million is is federal dollars.

There's some state grants we have.

That's just state GR, you know, general revenue fund or some other special fund.

The Fed decisions don't impact that at all.

But it will get challenging.

As member Frank mentioned, the changes to Medicaid through HR one, um, big big big beautiful bill will force the state to make some different decisions.

So that was my next question.

So when I mean, as how health care is going to start to get impacted, when do you think or when are you expecting that to affect you?

Will that be like middle of this year, later this year?

Already.

I mean, we Illinois, you know, made the decision to eliminate the health benefits for immigrant adults last uh July.

We saw a change in the number of uninsured patients that we're seeing already.

SNAP benefits have changed.

The Obamacare, the subsidies, affordable care act subsidies were eliminated earlier this year.

We see people who can't afford marketplace plans now, who are now in that uninsured bucket.

The bigger changes to Medicaid we expect to take place um this fall and early next year.

The work requirements kick in, I think October 1st, which we know will have a depressing effect on the number of people who are covered by Medicaid.

So can you predict any kind of percentage of how much more your number of people is going to go up that had that will not have health care, but will have to come to you for services?

Yeah, we're looking at percentage changes in the number of people who are uninsured and trying to forecast that for our own encounters.

Part of the good news is we have a diversified set of payers for those things.

It's not all Medicaid, but Medicaid is the biggest bucket.

Um, and so we do anticipate a lot of challenge and a lot of pressure if we're not seeing reimbursement for a Medicaid or managed care plans for those folks.

They're now in an uninsured status.

They don't have their paying out of pocket for that care.

We do anticipate changes when we expect to see that in the 27 budget.

Could the number of uninsured people double?

Um the number of people we see that are uninsured could could double.

Um, I don't think the number of uninsured people in in Lake County will double overall, um, but we expect tens of thousands of people to potentially lose access to Medicaid because of the policy changes.

Yeah, I guess I was looking at the people that would come to you.

Like I don't know how many come to you now that are uninsured.

Could that number double of people keep the number of people coming to you?

It could.

Um depends on what other healthcare institutions are able to see around the area and what care is available to them.

Um right now we see like about a quarter of our patients are uninsured.

Um I would be worried if it doubled.

Um, so I don't think it'll double, but I think we'll see an increase in the percentage of people and we could bring forecasts back to you.

Okay.

Thank you.

Remember, can you say?

Thank you.

Director Hoff, you and your staff are all experts in health care policy, which means I would assume you have a very clear understanding of how changes to health care policy impact people both directly and indirectly.

And we're hearing a lot in the last few minutes about um people who are, you know, quite vulnerable to losing their insurance Medicaid coverage, and how the changes that are coming to your department are gonna impact them.

Are you able to share with us, please, how these changes and these cuts will impact people who are not directly affected?

What are the indirect effects on members of the Lake County population who maybe aren't directly benefiting from some of these programs, but are still going to be impacted?

What will be the downstream effects to the county as a whole?

Yeah.

I mean, a number of effects.

One is increased uninsured rates in hospitals.

So we'll see more people without you know preventive care or primary care who wait and delay care because they can't afford it and they end up in the emergency rooms, which leads to higher volumes in emergency rooms, more boarding, more kind of overcrowding.

We know our hospitals are slammed, especially during respiratory health season.

So if you go and there's a two-hour wait now, maybe there's a four-hour wait because there's a larger number of people with acute care issues that could not take care of them earlier on workforce, right?

I mean, a lot of our um a lot of people across Lake County depend on Medicaid to be able to be healthy enough to go to work, go to school, take care of somebody.

Uh if they don't have access to that care, they may not be able to work to take care of somebody to go to school because they're dealing with their health issues.

Um I think the overall cost, right, for all of our health um systems, health organizations, less people with insurance means less people who are able to afford that care, means less ability to pay for those services.

And so whether that's hospitals or clinics or primary care offices, um, we see potentially higher costs being distributed because more people have no insurance, no way to pay for that.

Thank you very much.

I just want to comment, you know.

I'm very fortunate to represent one of the more affluent areas of Lake County.

Um, and I just really appreciate your sort of clarifying how we are all being affected, no matter who we are or where we live uh in Lake County, we're all being affected by this situation of chaos and uncertainty that's been inflicted upon us by the federal government.

And I just want to congratulate you and your staff and and give a comment.

Um and this goes for all of the directors here today.

Um, you know, it's pretty heroic uh the way you and your staff are have are behaving in response to to all of this chaos and uncertainty.

And I just want to make sure it's on public record that um all of these talented people on staff are you know putting themselves in and at great going through great efforts and um trouble to and uncertainty and the fact that you even have you know employees who have been told twice this year that they're about to lose their jobs and they're still here.

Uh I just feel like uh it's important that everyone within the sound of my voice recognizes how heroic our county staff is always, but especially during this period that we're going through.

Thank you.

Remember K.

I just want to make sure we clarify a couple of things that you asked, Patrice.

One is um, and I think Member Hart touched on this, but I just want to make sure is one is looking at the general policy of ending people's terminations at the side in at the end of the grant, right?

And and having more flexibility.

So I think the committee is generally saying yes, we support that.

So let's look at whatever policy procedure wise.

And the second is that we also want to look at additional funding to support in the event that we do get you know different levels of funding eliminated, how we would support that this year.

Right.

So I just want to make sure clear we're we're we're in alignment with those.

Yeah.

Okay.

That was the question from the committee.

Um we've been working on putting a structure around a very complex issue.

And uh just wanted your direction that we should continue to do so.

Yep.

Excellent.

I do need to jump for a quick phone call.

So if we want to the Mara's gonna take over if we do want to continue to hear from either Director Sereno or I can't who else is here that Dominican.

Well, and Dominic as well.

If you have questions, please continue.

Thank you.

Thank you.

Yeah, we were gonna hear from Dominic Streso next from community developments.

Oh, wait, Chris, we have another question for you.

Can you come back for a minute?

Thank you.

Okay.

Member Kasvan.

I just want to clarify uh a couple of um things you said.

So um, how much is the roughly the budget for the health department, the total budget budget?

Uh about 93 million.

Okay.

Um, and then you said um what like 25% of it is grants in general.

Um, some around 15% is federal.

About uh it's 12.8 million is federal dollars, federal grant dollars.

Okay.

It doesn't include all the Medicaid MCO reimbursements, but the grants specifically we're talking about today.

Yeah.

Um how much of that 12.8 million right now is questi questionable as far as uh all of it?

I don't know.

Okay.

Yeah.

Okay.

It's federal dollars.

So we've seen changes in a number of those programs.

We've heard about, you know, threaten uh threatened discussions about all of it potentially.

We've haven't heard word that any of it is safe or off the list.

Don't worry about it.

So we put them all on the list.

Is like these could be eliminated.

And that's I mean, that's smart for us to say anytime, right?

A grant is a grant, it could go away at any point in time, but you know, for these ones right now, with the amount of discussion going on, we put them all on a risk list.

Okay.

Um, so but that doesn't include, I mean, those are grants that we're not we're not including in that the amount that um we get reimbursed by Medicaid.

I'm wondering what that amount is and what percent what percent of it is perhaps going away.

I don't know if that's if you can project that it's really hard to do.

I think it's about 25 million in Medicaid reimbursement through managed care plans or fee for service to the state or number of other programs.

Um it doesn't sound like any of that is at risk, right?

Like Medicaid will continue.

It's the number of people who have Medicaid that come to us for service.

If we see fewer people who use Medicaid, we won't be re-immersed the same amount.

So we would expect to see fewer less revenue from Medicaid.

And we cover them regardless of whether they are do have any coverage like Medicaid.

So it would it would be a loss of funding.

So we'd have to find another source of that revenue.

So part of being a federally qualified health center is that you see anybody, regardless of their ability to pay.

That was the premise of federally qualified health centers since inception.

Yeah.

We do get a grant, about a five million dollar grant to that's supposed to help offset the cost of that care.

But that grant we have not heard any news that that's increasing as a result of the policy changes.

Okay.

So it seems like, okay, if it's 25 million in Medicaid reimbursements, say 50% of that goes away.

Um that's 12.5 million.

Okay.

Um though it could be less, we just don't know.

Okay.

Um thanks.

I just wanted to get an idea of the total totality of the issue.

Thanks.

So um, yeah, I just wanted to mention this just eats at me every day.

We're all paying in to these federal dollar buckets, and we've been giving these grants forever to fund all these vital services.

So if you're not getting the money, where's all this money going?

That's a that's a big question of mine every single day.

Who's getting all this money that we're all paying into the federal government?

It was it's vital for all these services, and I don't understand where it's going.

So all right, thank you.

We appreciate you.

Uh Dominic, thank you.

So just kind of looking at the impacts to community development.

Um, we are roughly about 90% or so federally funded, so almost entirely.

Uh our core programs, again, the entitlement program, C D BG, home, and ESG, we're kind of used to the whiplash in terms of the federal budget around those programs.

We've seen them get zeroed out in the past.

However, they've proved to be relatively stable in terms of Congress appropriating dollars.

Um, they've been continuously funded um for a while now.

So I think the threat there is more toward the the policy shifts and and things of that nature.

This year, what's been different as we've talked about here and what we were talking about earlier is the continuum of care funding.

And um that's roughly three and a half million dollars there.

That was through a policy change uh pulled.

You know, 90% of those dollars are supposed to be protected.

Um they notified us the day after reopening from the previous shutdown that only 30% of those dollars would then be protected and then sorry, only how much is it?

30%.

30%.

30%.

Um again, and that triggered the lawsuit again, that's ongoing.

Um, hopefully um, it's seemingly that the judge may rule in order in favor of the plaintiffs.

We'll hear soon.

Um, but again, there is still a potential for an appeal there and uncertainty around what that would look like.

So that that's been the biggest impact and what's been different this year as opposed to years past.

So have you gotten um uh notifications in the last few months that that this grant's canceled, that grants canceled, like what have you been hearing?

The notification came uh they call it the notice of funding opportunity that was put out again the day after they they reopened, and that had all the policy, including the the reduction in the protection of the cap.

So that's how we were notified of that.

Um they rescinded that and then reinstated it and then rescinded it again.

And now it we're we're tracking it through the court process is really uh communication from HUD has been sporadic.

Um, but we've been following it on our own really through the court process.

So it sounds like it just changes from day to day.

It does.

Uh we've been on track, they have been adhering to the the judge's order in terms of taking steps to process renewals.

They have not processed renewals, they're not required to renew by the current order that'll come hopefully with the final order.

Um, but they've taken steps and turned them in terms of accepting applications, giving instructions on how to apply for renewals, things like that, but no concrete steps.

And the big issue is is the timing.

We're already late on a normal calendar and this continues to delay.

Okay.

Any questions?

Yeah.

Member Kasman.

So with leases coming due, you know, every month, depending on when they were put in.

Are there leases that are in jeopardy, or do we have funding to meet those needs right now?

Or is that something you're gonna need from the county as well?

One of the tricky things around the continuum is that question that we are used, HUD is traditionally late in in a normal year in terms of renewing.

We are used to HUD is traditionally late in in a normal year in terms of the providers are used to floating.

I mean, to answer directly answer your question.

Yes, there are leases that are grant funded that have expired only a few.

No one's been lost any housing so far.

That the team meets weekly and goes through the list and make sure that no one has lost the agency providers have been floating the funds as they're they had been used to.

Um so that is that's first and foremost.

That number will rise as we move forward.

We have a a bunch more coming, you know, throughout the year, a lot in March, but yes, there are leases that are that are grant funded for grants that have not been executed yet.

Okay.

I'm I don't know, my c but my colleagues, um, but I would think that we would want to make sure we don't lose any of these placements, and I I would appreciate it if we we would all consider you know tapping into emergency funds to prevent that from happening because I think you know our partners, you know, they're the nonprofits.

I they uh they certainly have a certain amount of content contingency dollars that can you know it's can be very different from one organization to another.

Um but they're not you know taxpayer funded there.

So it's uh you know, it's it's it's a lot for everyone.

And I just I really appreciate you being um being in it.

And I um would support the county taking measures to ensure no one loses their placements.

Thank you.

Thank you.

Any other comments?

All right, thank you, Dominic.

Next up is Jennifer Sereno from Workforce Development.

Good morning.

Um, so through the Department of Labor, our funding has been fairly stable over the last year.

We have not received any notices saying certain grants are being cut or removed.

Uh the funding has been stable.

Um, what we've heard on a federal level, and we continue to hear is that the uh core funding we receive, the workforce innovation opportunity act, which is 80% of our budget.

Um is in the budget and at a flat rate at this point in time.

There is ongoing, you know, discussion between different committees and appropriation groups that certain programs should be eliminated.

But you know, just last week it's like no, um, right now it's flat going forward.

Okay.

Um, so that's the positive that we're bringing.

Department of Labor seems to be uh projecting out that consistency with the funding for job training.

All right.

So at this moment, you don't have a lot of worries.

Oh, there's plenty of worries of federal funding.

But I mean, there's no threat hanging over your head, no additional threat.

Any grant right, right, exactly.

Okay, well, that's good.

That's one positive new piece of news.

I that's what I take every day.

Okay, any questions for Jennifer?

Okay.

Thank you very much.

So, based on what you heard from those directors, you can see why we need to take a very um, you know, long and um direct look at each one of these programs and coming up with a structure that would allow the flexibility needed to kind of take into consideration the varying levels of certainty that they are feeling, as well as um you know, the impact on their customers.

So that's what we're trying to do.

And I I feel as though we've reached your accepted your consensus that we should continue with this exercise for future uh presentation.

Yeah, absolutely.

And I think also there should be a discussion at FNA.

And um, but I think PARA's zeroed in on, you know, those couple of points.

Yeah, that we care about.

Um it is on the agenda for Thursday.

I'm not positive that we'll be completely ready with all of those detailed fund balance questions.

Um again, this was like just the initial conversation with each of the committees to make sure that we were on the right track and that we had your consensus to continue.

Um, but uh yes, we can definitely uh look into that fund balance impact of any future um procedure that we put into place.

Yeah, I think we're all heavily invested in making sure that we keep these programs funded and coming up with the best, you know, funded for now, and coming up with the best way to do that.

And then obviously during budget discussions in 2026, we may know more, we may not know more, and but we'll have to have some innovative ideas at that point as well, depending on you know how the year has gone.

So thank you, Patrice.

We could not thank you enough.

This is another layer of work that now you've got to go through because there's so much uncertainty.

But we really appreciate all your efforts.

Thanks to the directors.

They're the ones doing the real work.

So thank you very much.

Thank you to all the deputy administrators.

Thank you.

Any further member remarks?

I feel like we made a lot of remarks today already.

Okay.

Um we are ready to adjourn.

Our next meeting will be February 24th, 2026.

Thank you, everybody.