Ramsey County Budget Committee of the Whole: Health and Wellness Performance Measures - September 1, 2026
Ramsey County Budget Committee of the Whole: Health and Wellness Performance Measures - September 1, 2026
The Budget Committee of the Whole met on September 1, 2026, to review supplemental budgets and performance measures for the Health and Wellness Service Team, including Community Corrections, Social Services, and Public Health. Presentations focused on outcomes related to justice transformation, racial equity, and resident-centered holistic supports. Key topics included reductions in youth out-of-home placement, felony revocation rates, Project Bridge, aging and disability services waitlist improvements, mental health access, child welfare disparities, tuberculosis incidence, WIC participation, and family home visiting. The meeting included farewell remarks to Deputy County Manager Nadir Abdi and Commissioner Ortega.
Presentation 1: Community Corrections (Director Monica Long)
- Youth in the Community: In 2025, 84% of Black youth and 83% of Asian youth remained in the community compared to 94% of white youth. American Indian youth remained at less than 80%. Overall, youth remaining in community increased from 74% in 2015.
- Felony Revocation Rate: Reduced from 29% in 2016 to 15% in 2025. The overall probation revocation rate is 8%; the 15% for felony-level reflects intensive supervision cases.
- Program Participation at RCCF: 98% of sentenced residents participated in programming. Pre-sentenced clients (Project Bridge) also showed high engagement; a video from a resident highlighted certificates, therapy, and medications.
- Project Bridge: Launched April 2025, helping alleviate overcrowding at the Adult Detention Center. About 60 clients (15% of ADC population) were transferred. Costs were absorbed operationally in 2025 but are now included in the 2026-27 base budget with $2 million in ongoing funding approved by the board.
- Unsheltered Population Team (UP): Worked on encampment closures; 29 clients resolved warrants, and 30 additional warrants are with courts. The team received the Minnesota Corrections Association President's Award.
- MRRA (Minnesota Rehabilitation and Reinvestment Act): Began September 1, 2026. An unfunded mandate; no housing or resource funding provided to counties. Community corrections has a 58-employee deficit (out of 477 complement). Staffing and costs will be closely monitored.
- Women's Judges Group: Over 4 years, 110 women attended; 23 attended more than 10 times. Zero recidivism among attendees.
Presentation 2: Social Services (Director Sophia Thompson)
- Turnover: Lake Owasso residents saw 27% turnover in 2024, decreasing in 2025 with stable leadership. Overall, turnover is disaggregated by race, age, and gender internally.
- Aging & Disability Services: Long-term care assessments (MnChoices) waitlist reduced from 7 months to 1 month for developmental disability waivers. Currently less than 70 people on waitlist (down from 1,819). 80 new staff hired and trained by late 2025/early 2026, approved by board. Compliance with 20-day statutory face-to-face assessment is met for under/over 65; DD assessments average 27 working days.
- Adult Mental Health Targeted Case Management: Timely access (within 10 days) improved from 18% in 2022 to 22% in 2025 (108 of 491 referrals). New pathway via CCBHCs (Clues, People Incorporated, Wilder, Frazier) now available. Demand growing: from 3,200 residents in 2015 to over 4,000 currently.
- State Operated Services Discharges: Cost doubled since 2021 to over $17 million in 2025. New positions (financial worker, aging/disability partnership) added in 2026 to address barriers. Mentally ill and dangerous population rose from 30 in 2014 to over 100 in 2026.
- Child Welfare Disparities: American Indian children are 43 times more likely than Asian children to be in out-of-home placement. African American children also disproportionately represented. In 2025, disparities increased, but structural changes (prevention services, ICWA/MIFPA training, safety organized practice) have been implemented. Future focus on culturally grounded partnerships and lived experience voices.
Presentation 3: Public Health (Director Amy Cameron)
- Clinic Visits: Over 70,000 clinical encounters at correctional facilities in 2025. Tuberculosis clinic saw 845 patients during 7,472 visits (avg. 9 visits/patient). 75% of immunization clinic clients were uninsured/underinsured. 56% of TB clinic clients spoke a language other than English. Over 80% of Clinic 555 clients had income ≤250% FPL.
- Tuberculosis Incidence: Ramsey County incidence 5.2-7.4 per 100,000 (2020-2025), about 40 cases/year. Goal aligns with Healthy People 2030 (1.4 per 100,000). Partnerships with Washington and Dakota counties. Multi-drug resistant outbreak in 2016 highlighted challenges.
- Hazardous Waste Collection: Environmental center opened April 2025. Participants increased from ~32,500 (2020) to nearly 41,000 (2025). Metro-wide reciprocal use agreement with 7 counties.
- WIC Participation: Over half of Ramsey County babies receive WIC. 90% of eligible infants served in 2025. 17,500 participants per month. 65% of staff from communities of color; over 12 languages spoken. Goal: increase percent of mothers participating >3 months of pregnancy (current rates not specified in presentation).
- Family Home Visiting: Provides public health nurse visits to pregnant/parenting families (ages 0-3). ROI $1.80 to $5.70 per dollar spent. During Operation Metro Surge, staff helped clients procure over $10,000 in basic needs but missed 151 visits.
Key Outcomes
- Decisions & Next Steps:
- Community Corrections will closely monitor MRRA costs and staffing deficits and report to county manager.
- Board workshop on aging and disability services progress scheduled for September 22, 2026.
- Public Health will explore expanded partnerships for mobile services (Care Van) and work with medical assistance providers to increase early WIC enrollment.
- Social Services will continue tracking turnover and child welfare disparities; future measures may include disaggregated data and whole-family support outcomes.
- Farewell to Deputy County Manager Nadir Abdi, who will transition; County Manager Becker acknowledged the complexity of Health and Wellness work.
- Funding & Budget: The board's 8.25% levy increase included $2 million ongoing for Project Bridge. State and federal grants for WIC and TB clinics are stagnant or decreasing; county invests additional levy dollars.
- Monitoring: Several measures will be refined with better data collection tools (e.g., case management system for corrections; improved turnover surveys countywide).
Meeting Transcript
Good afternoon, everyone, and welcome to the budget committee of the whole. Today the Health and Wellness Service team continues a series of presentations. Presentations that focus on performance measures. Today we are looking forward to exploring assessments on of the county elfers who support the health and well-being of residents in areas like mental health, disability services, prenatal and infant health, and services for justice involved residents. Today we would focus on three areas community corrections, social services, and public health. So with that, I would like to hand it over to Deputy County Manager Nadir Abhi to introduce the health and wellness presentations. Welcome. Please introduce yourself and share thank you, Chair. Um good afternoon, everyone, the dear Appy Deputy County Manager for the Health and Wellness Service Team. Um Chair, thank you for the opportunity. Uh Commissioners, County Manager Beckard. Um before we begin today's health and wellness budget presentation, I just would like to take a few minutes to say something uh personally to me. Um as many of you know, uh, this is my final budget presentation with Ramsey County as the Deputy County Manager of the Health and Wellness Service team, and as I thought, you know, it'll be a good time to kind of just say a few things. As I thought about today, I realized that uh this is a unique moment because Commissioner Ortega it's also we'll be completing as many years at the end of the year, and I'm sad that I won't be there to celebrate with you, sir. Um Commissioner Thick, I just wanted to say a few words. I didn't I didn't want this opportunity to pass by without recognizing you and thanking you. You have dedicated many years of your life to public service and to the residents of Ramsey County. Your legacy is not only simply by measured by how long you have been here and served, but it's also a reflects on the issues that you have championed for, the difficult questions you've been asking and willing to ask. Um your consistent focus on ensuring that county government works for all communities. One thing I appreciated during our time together or our brief time together is your willingness to challenge us with difficult questions and hold us accountable for things that you know you think that is appropriate for us to do in regards to serving people, um, the residents of Ramsey County. That is uh especially something that means a lot to me, especially when we met at the government center opening and we had a 20-minute conversation. I realized in that short period of time who you were and what you stand for and what you championed for. So thank you for giving me that opportunity that day and just having conversations with me. Um as I prepare for my own transition, I'm grateful for our past that crossed, and I've appreciated your leadership, um, your perspective and your commitment to Ramsey County. So, with that, Commissioner Ortega, I would like to say thank you for your service, your legacy that you will leave behind, and I wish you and your family all the best in your next chapter. I'm not sure what you're gonna do next, but maybe golfing, fishing, something. But thank you. Thank you. All right, so with that, and the spirit of service and stewardship in mind, I would like to now get back to the scheduled uh hearing here with uh the health and wellness presentation. I would like to turn um that work that we have done, and before the department leaders begin presenting the health and wellness performance measures, I wanted to take a moment to thank them and thank everyone that's in the room today for all your hard work, dedication, uh, passion, commitment, and the opportunity to serve alongside all of you. The work of health and wellness is incredibly broad and complex. Every day our employees are supporting residents and families, responding to challenging community needs, navigating state and federal changes, managing physical pressures, and continuing to find better ways to deliver services. I wanted to take that opportunity to just thank one more time the um leadership and the thousands of the many employees across the health and wellness who makes this possible. The measures you will hear today are more than just numbers on a slide. Behind each one, our employees doing their work, community partners working alongside us, and the residents and families who depend on the services that we provide. As this will be my final presentation, I wanted to personally say thank you to everyone once again. It's truly been a privilege to work alongside leaders and their teams, and I'm grateful for their partnership commitment and the way that we continue to show up for our communities as a whole. We were very intentional in selecting these measures that we're going to be presenting today, as you will acknowledge that some of them turned out to be a little bit longer than originally anticipated, but as you all know, health and wellness is a special kind of service area. Our work doesn't always fit neat neatly into a slide or a measure. So we'll try to keep it tight and keep us moving in the right direction so that we get done on time. More importantly, today is about connecting these measures to the work happening every day, what we're seeing, what we're learning, what we're making progress, and what we're challenged, what are the challenges that are remaining. For today's presentation, you'll hear from Director Long from Community Correction, followed by Director Thompson, Social Services, and lastly but not certainly not least, Director Karen from Public Health. Each director will walk you through their selective measures and provide some context about the data that is telling us and how it connects to the work for their teams. And I don't want to forget anyone. So I just wanted to say I appreciate everyone's commitment, passion, and work that has been done over the years that I've been in the service area. I appreciate your going through the challenge times together. And I just want to say thank you one more time to everyone that has been part of this service team and everyone that has been contributing to this presentation and the measures that we've worked on since April or so. With that, Chair, I'll uh turn it over to you. Um I think the next presenter will be Director Long that's gonna get us started. Yes.
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