APPENDIX H: COUNTY SPECIFIC INFORMATION



COUNTY SPECIFIC INFORMATION Anoka County:County Administration:Agency Name:Anoka County Human ServicesDirector’s Name:Cindy Cesare, Division ManagerAddress:2100 Third Avenue, Anoka, MN 55303Telephone Number763-324-1411County Agency Contacts:Area of ResponsibilityNameTitleTelephone Number/Email AddressSocial ServicesJerry PedersonDirector – Community Social Services and Behavioral Health763-324-1451Jerry.Pederson@co.anoka.mn.usHealth Care EligibilityBrad ThielDirector- Economic Assistance763-324-2418Brad.Thiel@co.anoka.mn.usPublic HealthJonelle HubbardDirector – Public Health and Environmental Services763-324-4224Jonelle.Hubbard@co.anoka.mn.usBehavioral Health – Adult Denise KirmisManager – Behavioral Health and Adult Services763-324-1406Denise.Kirmis@co.anoka.mn.usBehavioral Health - ChildrenJess VanKuykManager – Children and Family Services763-324-1493Jess.VanKuyk@co.anoka.mn.usSubstance Use DisorderDenise KirmisManager – Behavioral Health and Adult Services763-324-1406Denise.Kirmis@co.anoka.mn.usTransportationJessica LethProgram Manager, Economic Assistance763-324-2504Jessica.Leth@co.anoka.mn.usGeneral County Service Delivery and AccessAnoka County is located north of the Twin cities and is comprised of 21 cities and towns, encompassing approximately 446 square miles. As of 2010 Census, the county had 330,854 residents, making it the fourth most populous county in Minnesota. Anoka County has many rural areas but is also close to Minneapolis and St. Paul. Anoka has a robust collaborative, known as the North Metro Roundtable that consists of membership from the following areas: local mental health and addiction providers, county social services and corrections, law enforcement, jail administration, Allina Health, and NAMI. This group has been working on integration of services, stigma reduction, and housing resource. Healthcare is also an important member of this collaboration. This group has looked at existing services, gaps in services, and areas we can influence to improve access and quality of services. In addition to this group, the county has an active mental health director’s network who has current membership of many of the above entities and includes all of our contracted health plans. This group has been in existence for many years and has been a wonderful way for providers to connect with each other and get information on changes from the state and county. Residents of Anoka County access services through their local providers throughout the county. Since we are close to Minneapolis and St. Paul, many clients do travel to these cities for routine care, especially those seeking care from providers who speak their primary language and understand their culture. Transportation continues to be a challenge with accessing services, especially for residents in the rural parts of the county where public transportation is not established. Telehealth is important and will continue to be important after the pandemic for those who cannot easily get out to appointments. It is a challenge for residents to find dental providers who are accepting new patients. Specialty dental care and orthodontia providers are especially limited for Medicaid enrollees in Anoka County. There are health services that are limited in their availability in Anoka County. Psychiatry and med management providers for children and adults have been limited. There have been long waits for specialty assessments (such as neuropsychological and fetal alcohol). Not only are these assessments needed for appropriate care and treatment, the results of these assessments can impact other critical outcomes, such as the amount of funds available for adoption assistance. There is a minimal number of therapists and treatment providers for youth who have been sexually abused. Crisis stabilization is also a limited service for clients in our county. We have beds available to us by People Inc.; however, they are not located in our county. We have had an increase in the number of youth we have had to send out of state due to a shortage of residential treatment facilities for youth with complex trauma and suicide attempts or physical aggression in their background. Self-care and wellness resources are needed more now than ever before, and members need to be made aware of all of the health care services that are available. Carver County:County Administration:Agency Name:Carver County Health and Human ServicesDirector’s Name:Rod FranksAddress:602 East Fourth Street, Chaska MN 55318Telephone Number(952) 361-1600FAX Number:(952) 361-1660County Agency Contacts:Area of ResponsibilityNameTitleTelephone Number/Email AddressSocial ServicesHeather GoodwinDeputy Director (952) 361-1605hgoodwin@co.carver.mn.us Health Care EligibilityKate Probert FagundesDepartment Manager(952) 361-1713kprobert@co.carver.mn.us Public HealthRichard ScottDeputy Director(952) 361-1320rscott@co.carver.mn.us Behavioral Health -AdultRichard ScottDeputy Director (952) 361-1320rscott@co.carver.mn.usBehavioral Health -ChildrenMichelle SelingerDepartment Manager (952) 361-1661mselinge@co.carver.mn.us Substance Use DisorderRichard Scott Deputy Director (952) 361-1320rscott@co.carver.mn.usTransportationKate Probert FagundesDepartment Manager(952) 361-1713kprobert@co.carver.mn.usGeneral County Service Delivery and AccessCarver County is located approximately 30 miles west of Minneapolis and contains eleven communities (Carver, Chanhassen, Chaska, Cologne, Hamburg, Mayer, New Germany, Norwood Young America, Victoria, Waconia, and Watertown). While it is part of the seven-county Twin Cities Metropolitan Area, Carver County is unique in that we are a blend of suburban and rural populations with two distinct demographic regions. The western portion of the county is rural and agriculture-based, and the eastern side is comprised of rapidly growing suburbs. According to the MN State Demographic Center, the 2019 population estimate for Carver County is 107,179. Carver is 93% white; approximately 6% of Carver County children speak a language other than English at home. While there are many diverse, non-traditional services available to minorities in the adjacent metropolitan area, there are few such services in Carver County. Transportation from the rural parts of the county is an ongoing challenge and especially for those who have limited dollars to spend on travel. There are roughly 33,419 households and 42% have children under age 18 living at home. Carver County has roughly 5% of its population under the poverty line. Carver County enrollees struggle to find local low-cost dental care, mental health services, and affordable, easy-to-use transportation.? Access to care requires not only financial coverage, but also access to providers. The availability of dental services for public-program recipients is a reoccurring challenge due to limited providers, long wait times for appointments, and transportation barriers to available providers; many are quite a distance for our enrollees depending on where one resides in Carver County. Public transportation services in Carver County include: SmartLink Transit (Dial-a-Ride, Medical, and Volunteer Drivers); SW Prime (Dial-a-Ride for Eden Prairie, Chaska, Chanhassen, Carver, and Victoria); SW Prime MD; SW Transit; Metro Mobility; and WeCab. Starting on January 1, 2020, Chaska and Chanhassen residents could no longer use SmartLink for trips that started and ended in Chaska or Chanhassen and must instead use SW Prime. This decision has increased the transportation challenges for many of our low-income residents who may also have language barriers, literacy issues, and/or are affected by the digital divide. Carver County attempts to combat access issues in the area of behavioral health by operating a mental health center in Waconia with a satellite office in Chaska. The center provides outpatient clinic services, child psychiatry, adult targeted case management, housing support, and mobile crisis services. Day Treatment is provided at a site in Chanhassen. Transportation is a frequent barrier to accessing mental health services and lack of affordable housing often creates an unstable living environment, which can be a social driver impacting sustained mental wellness. Pandemic waivers have allowed the center to provide needed services via telehealth. This has worked well for many enrollees and has received positive feedback along with requests for that option to continue long-term when appropriate. Carver County has two outpatient substance use disorder providers. Hazelton and Five Stars Recovery Center, both in Chaska. Five Stars also provides sober housing and outpatient treatment services with housing. Carver County Human Services provides children’s mental health targeted case management services to eligible children. There are no residential programs for mental health within Carver County. Carver County has a very limited capacity to provide diagnostic assessments to infants/toddlers and limited availability to provide evidence-based trauma therapy for children and families. Simplifying the process for private providers to become in-network providers will help with access. Carver County Public Health provides a wide array of essential services, which include preventing the spread of disease, protecting against environmental hazards/injury, promoting, educating, and encouraging healthy behaviors, responding to a disaster or pandemic, car seat/CarFit education/clinics, and immunization clinics for those eligible. Carver County would benefit from extra support of the Statewide Health Improvement Program (SHIP) grant efforts and early childhood development services, such as home visiting. In 2019, Carver County completed a community health assessment. Issues related to mental wellness, transportation, and housing all rose to the top in that assessment. Dakota County: County Administration:Agency Name:Community Services AdministrationDirector’s Name:Marti FischbachAddress:1 Mendota Rd W, Suite 500, West St. Paul, MN 55118Telephone Number(651) 554-6560FAX Number:(651) 554-5948County Agency Contacts:Area of ResponsibilityNameTitleTelephone Number/Email AddressSocial ServicesEvan HenspeterSocial Services Director651-554-6344Financial AssistanceAbdi NadirDirector651-554-5953Public HealthBonnie BrueshoffPublic Health Director651-554-6103Behavioral Health – AdultsEmily SchugSocial Services, Deputy Director651-554-6316Behavioral Health – ChildrenSuzanne TuttleSocial Services, Deputy Director952-891-7326Substance Use DisorderEmily SchugSocial Services, Deputy Director651-554-6316TransportationMadeline KastlerSocial Services, Deputy Director651-554-5918Community CorrectionsMarti Fischbach (Interim)Community Corrections Director651-554-6560Workforce ServicesMark JacobsWorkforce Services Director651-554-5622General County Service Delivery and Access:Dakota County is located in the southeastern section of the 7-county Twin Cities Metropolitan area. As of 2019 American Community Survey, the county had 429,000 residents, maintaining its third largest county status in Minnesota. Majority of county residents live in cities and suburban residential areas, with more sparse populations living in rural areas in the south and southeast sections of Dakota County.Dakota County has two hospitals - Fairview Ridges in Burnsville and Regina Medical Center in Hastings, as well as one border hospital to the south in Northfield, and several hospital options in St. Paul, MN on the northern border. Apart from acute hospital care, Dakota County has 8 Urgent Care Clinics, 10 Convenience Center locations, and 9 Nursing Home facilities. With well over 3 dozen Primary Care clinics and a variety of specialty care providers, Dakota residents have many options to choose from for their health care needs. With metro sprawl and convenience, residents will use providers in neighboring metro counties, including providers located in Ramsey, Scott, Hennepin and Rice County.Some resources are limited in Dakota County, for Public Program recipients, including mental health professionals, substance abuse providers, oral surgeons and a steadily increasing lack of dental providers accepting Medical Assistance. In addition, specific service providers lack services such as injectable medication provided at a clinic level.The lack of specialty services countywide limit clients’ ability to access these services, while placing a strain on remaining providers. As a result, DC clients have longer wait times due to the demand and availability of the respective services.Specifically, access to care in the eastern most part of the county (like Hastings, MN) is limited to the mainly Allina Clinic system, allowing little clinic choice options for nearby residents. Limited access, occasionally prevent clients from on-time arrivals for appointments, which sometimes results in them being dropped from that provider. This can create undue hardship for the client with limited or no options for alternative service offerings. Eligible clients can obtain transportation via MNET who receive regular Medical Assistance and via each of the MCO’s ride programs for any client enrolled in a prepaid MCO/MA health plan. (Note: Common carrier transportation is not available to MinnesotaCare enrollees). Volunteer programs also exist for those not on a public program, via county-specific contracts. Despite having these transportation options, they still do not adequately cover the rural regions of the county.Finally, based on Dakota County’s demographic projections, the county’s cultural diversity is changing. Consequently, there is a greater need to identify and address the cultural and language barriers that prevent certain populations from accessing the county services. Hennepin County:County Administration:Agency Name:Hennepin County Director’s Name:Jodi M. Wentland Address:300 So 6th St MC 233 Minneapolis, MN 55487Telephone Number612-543-4344Email Address:Jodi.Wentland@hennepin.usCounty Agency Contacts:Area ofResponsibilityNameTitleTelephone Number/Email AddressSocial ServicesMichael Herzing Human Services Director612-596-1371Michael.Herzing@hennepin.usHealth Care EligibilityMay XiongHuman Services Director 612-543-3012May.Xiong@hennepin.usPublic HealthSusan Palchick Public Health Director 612-348-3045Susan.Palchick@hennepin.usBehavioral Health – Adult and ChildrenLeah KaiserBehavioral Health Senior Department Director 612-596-1779Leah.Kaiser@hennepin.usSubstance Use DisorderLeah KaiserBehavioral Health Senior Department Director612-596-1779Leah.Kaiser@hennepin.usTransportationPatricia Avery Well-Being Senior Dept. Administrator612-348-7552Patricia.Avery@hennepin.usLong-term Services and SupportsLouella KauferAccess, Aging and Disabilities Senior Dept. Administrator612-348-3471Louella.Kaufer@hennepin.usHousing Stability David HewittHousing Stability Senior Department Administrator 612-543-3650David.Hewitt@hennepin.usGeneral County Service Delivery and AccessHennepin County is the most populous county with almost a fourth of Minnesota’s residents within its borders. It’s almost 1.2 million residents live in communities that range from inner city neighborhoods to suburbs and rural areas. It has tremendous diversity in the make-up of its population. Per the 2010 census its racial and cultural diversity has been increasing significantly and 13% were foreign born. Poverty levels have also increased as 9% of Hennepin families were in poverty in 2010 as opposed to 5% in 1999. There are 12 hospital systems within the county.While many of our residents enjoy the great quality of life this region gets recognized for, we cannot be blind to the fact that stark disparities exist – particularly for our residents of color. Hennepin County has declared racism a public health crisis. Due to racism, Black, Indigenous and people of color in Hennepin County statistically have poorer educational outcomes, earn less, and are less likely to own homes or have access to quality health care and jobs than White people. These disparities have lifelong impacts, including higher disease rates, and, as we are seeing now, higher rates of COVID-19.2 Hennepin County defines disparities as differences in areas of life that result in one group having a disproportionate burden of negative life outcomes. It is our commitment that we reduce these disparities. We have an obligation to work toward eliminating disparities by whatever means we have. Here, in Hennepin County, inequities in education, employment, health, housing, income, justice and transportation are starkest between residents of color and their White counterparts.2? Among the key health, related services Hennepin County provides that are critical to supporting children, families, and single adults are:Behavioral Health – Our goal is that children and adults living with mental illness, substance use disorder or both can receive integrated, person-centered, recovery-focused interventions. Our approach involves coordinating services, policies, resources and data in a countywide framework – across Human Services, Public Health, and Health. The rate of people living with mental health issues is consistent across racial communities, but the negative impact of living with those conditions is compounded when things like access to care or housing or insurance are provided unevenly. In addition, people of color tend to come into contact with law enforcement at greater rates, and face stigma and criminalization of their mental health. Transportation - Hennepin County serves as fiscal agent for a 13 county Metropolitan County Consortium (MCC). The MCC is comprised of the following Minnesota Counties: Anoka, Benton, Chisago, Dakota, Hennepin, Isanti, Mille Lacs, Pine, Ramsey, Sherburne, Stearns, Washington and Wright. Housing Stability - We provide resources to people currently experiencing homelessness and provide resources for sustainable housing in the future. Those experiencing homelessness in Hennepin County are overwhelmingly people of color. In addition to higher rates of poverty, people of color face compounding factors based on racial inequities from different systems, and they tend to pile up. Less access to well-paid jobs and affordable housing makes it hard for many people of color to find stable homes, and disparity-related barriers including criminal convictions and evictions make it difficult to secure the housing that exists. We must identify disparities in housing to help us identify where the barriers are, and how we shift programming to respond to specific needs.Aging, Access, and Disabilities - Seniors and people living with disabilities can turn to Hennepin County’s Aging, Access and Disability Service area for help with assessments and connections to services to help them live as independently as possible. People with disabilities and older adults have greater disparities in income, compared with the general population. Though the system has improved to provide more opportunities than past generations had, the added impact of racial disparities in health and income magnifies that difference for seniors and people living with disabilities.Hennepin County Board of Commissioners resolution: Racism is a public health crisisHennepin County Commitment to disparity reduction. Ramsey CountyCounty Administration:Agency Name:Ramsey County Health and Wellness Service TeamDirector’s Name:Kathy Hedin, Deputy County ManagerAddress:160 East Kellogg Blvd. Saint Paul, Minnesota 55101Telephone Number651-266-1461FAX Number:651-266-4439County Agency Contacts:Area of ResponsibilityNameTitleTelephone Number/Email AddressSocial ServicesAnne M. BarryDirector651-266-4417anne.barry@co.ramsey.mn.usFinancial AssistanceTina CurryDirector651-266-4365tina.curry@co.ramsey.mn.usPublic HealthKathy HedinDirector651-266-2461kathy.hedin@co.ramsey.mn.usBehavioral Health - AdultSophia ThompsonInterim Division Director651-266-4515sophia.thompson@co.ramsey.mn.usBehavioral Health - ChildrenKim CleminsonDivision Director651-266-3882kimberly.cleminson@co.ramsey.mn.usSubstance Use DisorderBill CalmbacherDivision Director 651-266-3623william.calmbacher@co.ramsey.mn.usTransportationAli AliManager651-266-3849ali.ali@co.ramsey.mn.usGeneral County Service Delivery and AccessMore than 550,000 Minnesotans make their homes in Ramsey County. Located in the heart of the seven-county Twin Cities metropolitan area, it is the second-most populous county in Minnesota with about 10 percent of the state’s residents. Predominantly urban,?Ramsey?is Minnesota’s smallest and most densely populated county, spanning 170 square miles. Ramsey County communities are nationally known as attractive, livable places rich in history, diversity and opportunity.Ramsey County Social Services is committed to eliminating racial disparities in service delivery for communities of color. It has been determined that there are a number of instances where service utilization and service outcomes are not equivalent across racial or ethnic groups. These disparities raise questions about whether we are providing equitable access to services for all groups, and whether the services are effective in achieving comparable results across cultural and racial groups.Ramsey County offers a wide variety of services to help people of all ages who are experiencing various emotional and/or behavioral problems associated with chemical dependency or substance abuse along with co-occurring mental health difficulties.Chemical Use Assessments and referrals to chemical dependency treatment, housing, and other services are provided to Ramsey County residents by the Chemical Health Unit. For residents that do not have health insurance, assessments of one’s use of alcohol or other drugs are provided on a no fee basis, or for a charge on a sliding fee scale based on income and number of dependents. The Chemical Health unit also serves as an access point for State licensed chemical dependency treatment services for qualified individuals meeting both State income and clinical eligibility guidelines for public funding. Referrals to supportive Group Residential Housing (GRH) for eligible persons with chemical dependency are also provided. Treatment resources for co-occurring mental health and substance abuse disorders are also available through the Chemical Health Unit. It is estimated that 60% of people who experience a mental illness also experience a co-occurring addition to alcohol or drugs. Research has demonstrated the need to treat co-occurring disorders through integrated treatment. Detoxification is provided by the Ramsey County Detox Center for adults and adolescents, 24 hours per day, seven days a week. The Detoxification Center is a residential facility providing medical monitoring, chemical dependency assessments, screening, and referral to appropriate treatment programs for individuals who are intoxicated or experiencing withdrawal symptoms. Service Coordination/Case Management provides information and referral resources; coordination of services; crisis intervention and community outreach as an alternative or adjunctive service to other types of chemical dependency treatment. Case managers assess, with the client, family members, and other professionals, what services are appropriate for supporting recovery. Case managers then arrange, coordinate and monitor services and also provide some of these services directly. Chemical dependency issues identified in Ramsey County:Lack of programming for mothers with children.Increased funding for intensive case management.Providers unable to service medically complicated clients.Increased programming for dually diagnosed clients.Lack of programming for sex offenders.Limited aftercare servicesIncreased support for transportation to treatment.Expansion of psychiatric and medication management services in residential programs.Most people served by Adult Mental Health are individuals with the most severe forms of mental illness and they receive publicly funded health care or are uninsured. Many of these men and women also experience additional challenges, including medical problems, chemical addiction and poverty. All individuals receiving case management services meet the state statute definition of serious and persistent mental illness, commonly referred to as SPMI. Services are provided by county staff and contracted agencies. The Ramsey County Mental Health Center serves persons with both SPMI and acute mental illness. An individual with an acute mental illness is one who has a mental illness that is serious enough to require prompt intervention. Outpatient Services are provided through a variety of clinics that individuals access through their MCO network. Adult Mental Health issues identified in Ramsey County:Lack of resources for childcare and transportation create barriers for accessing care.Bicultural and bilingual mental health providers are quite limited and the cost of providing interpreters is very high for agencies.Clients experience numerous challenges navigating health system which could be mitigated through the assistance of a care coordinator. This would result in an increase treatment compliance and response.Individuals with mental health or chemical health problems report that health care providers lack empathy and understanding of their disorders. In Ramsey County, Children’s Mental Health Case Management (Rule 79) is provided through the Ramsey County Children’s Mental Health Collaborative (RCCMHC). Social Services and the Saint Paul and suburban school districts, Community Corrections, providers and parents oversee the provision of case management and other services such as mentoring and intensive in-home therapy that support the plans for families who meet eligibility. Other services including respite and residential treatment are also provided through Mental Health Services when found to be essential to the child’s mental health care plan. Funding for the services accessed by the Collaborative and County may come from private health insurance (third party), MA, and county funds as available Ramsey County also offers mental health screening to all youth in Child Protection and Corrections/Delinquency.Diagnostic assessments and short-term case management for those youth and others referred who are having difficulty due to waiting lists and/or lack of insurance is a provided service.Ramsey County provides 24/7 crisis response to families with children with mental health concerns. Ramsey County meets monthly with the seven metro counties to work on providing high quality crisis service throughout the metro region.Children’s Mental Health issues identified in Ramsey County:Lack of child psychiatry including neuropsychiatry.Lack of safety net for children who are refused admission to hospitals and other residential settings due to aggressive behaviors.Limited number of professionals experienced in working with co-occurring disorders (including chemical dependency and developmental delays).Insufficient number of experienced in-home therapists.Lack of services for youth transitioning to adulthood, especially for those who do not qualify for adult mental health case management.Limited number of professionals that meet the cultural and language needs of families.Ramsey County is one of eight (8) metropolitan counties in the Metro Counties Consortium (MCC) whose membership consists of Anoka, Chisago, Dakota, Hennepin, Isanti, Sherburne, and Washington. The MCC have formalized the terms and conditions through which they will cooperatively manage and administer Access Transportation Services (ATS) of Non-Emergency Medical Transportation (NEMT) services by way of a Cooperative Agreement. Medical Transportation Management, Inc. (MTM) was selected by the MCC as a qualified vendor to provide brokerage services for ATS of NEMT. MTM manages this benefit by contracting with local, private and public transportation providers. Ramsey County Public Health provides a wide array of essential public health services which include preventing the spread of disease, protecting against environmental hazards, preventing injuries, promoting and encouraging healthy behaviors, responding to disaster, and assuring the quality and accessibility of health services. Our mission is to improve, protect, and promote the health, environment and the well-being of people in our community.Ramsey County is fortunate to have a network of community clinics which are available to serve the medical and dental needs of clients in our community. However, medical services are more readily available than dental services. Dental services are more challenging to obtain both in terms of accessing timely appointments, and availability of accessible locations. Low reimbursement rates affect availability of services. Clients access dental care by contacting the clinic for an appointment. Information on providers who accept MA and MinnesotaCare is provided via Public Health and Web link. There is a lack of dentists who accept MA which results in long delays accessing care.Requests for public health nurses to make home visits have increased, and staff identify that it is difficult for clients to obtain affordable chore and homemaking services.Scott County:County Administration:Agency Name:Scott County Health and Human ServicesDirector’s Name:Pam SelvigAddress:200 Fourth Avenue West, Shakopee, MN 55379Telephone Number952-496-7751FAX Number:952-444-9803County Agency Contacts:Area of ResponsibilityNameTitleTelephone Number/Email AddressSocial ServicesBarb DahlSocial Services Director952-496-8151bdahl@co.scott.mn.usHealth Care EligibilityKari OuimetteEconomic Assistance Director952-496-8540kouimette@co.scott.mn.usPublic HealthLisa BrodskyPublic Health Director952-496-8520lbrodsky@co.scott.mn.usBehavioral Health - AdultDanielle FoxAdult Services Manager952-496-8529dfox@co.scott.mn.usBehavioral Health - Children Suzanne ArntsonChild Welfare Manager952-496-8212sarntson@co.scott.mn.usSubstance Use DisorderSuzanne ArntsonChild Welfare Manager952-496-8212sarntson@co.scott.mn.usTransportationAlan HerrmannTransit Supervisoraherrmann@co.scott.mn.us952-496-8610General County Service Delivery and AccessThe Minnesota State Demographic Center states that in 2019, Scott County had an estimated population of 148,458 residents. This is an 8% increase from the 2013 estimate of 136,926 residents. By 2030, it is expected to grow to 172,140, an increase of 15.9% from 2019, and at a much faster pace than the statewide average (5%).In March 2020, the unemployment rate for Scott County was among the lowest in the state at 2.9%. Since then, it peaked at 9.9% and most recently, in September 2020, has declined to 5.2%. The median household income is $97,744, which is the 2nd highest in the State. This leaves approximately 5.8% of the population living below the poverty level.When residents in the county do access health care, they do so through the following ways:Primary care clinic or physician: Some residents currently have someone who is their primary care physician. This could be someone located in the county or in a different county. Urgent Care or Emergency Room Care: For individuals who do not have a primary care physician or clinic they are connected to, some individuals seek out emergency or urgent care services. Urgent care is also sought out for non-life threating illnesses that provide the convenience of evening and weekend hours.Convenience Care: Available in various retail stores and pharmacy locations, also for individuals with certain non-life threatening illnesses Scott County Mobile Clinic: Residents who are uninsured, underinsured or underserved, receive services via a clinic that goes to various locations in Scott County every two to three weeks. They provide adult and child health screening, preventive care, and health information.River Valley Health Services: This provider serves uninsured and under-insured people in Scott County by connecting them to local resources and free or low-cost health care services.Scott County Public Health: Public Health staff provides immunizations, child and teen checkups, education and referrals to county residents.St. Mary’s Clinic: St. Mary’s provides free health care to low income, uninsured persons residing in the seven county metro.The largest obstacle to accessing health care in the county is lack of transportation options. Without access to a car, residents have limited options for getting to or from a health care appointment. SmartLink is the Dial-A-Ride, ADA, and Medical Assistance service provider for both Scott and Carver counties. Other public transportation is very limited. There is currently no inpatient Chemical Dependency treatment available for women, and for men, it is limited to one provider. As a result, often times people must travel far distances to seek treatment.Heath care services that are limited in their availability to the County’s residents include dental and vision providers that accept Medical Assistance and specialty care such as nephrology, cardiology, and infectious disease care, in Scott County. Many residents are required to travel to Minneapolis for these types of services. The lack of specialty care increases transportation barriers and staff time spent on transporting recipients to receive necessary care. There are also minimum resources for infectious disease. For example, Scott County has a contract with Hennepin County regarding Tuberculosis. Additionally, there is a lack of culturally specific providers within the County, which creates communication/language challenges and other barriers for our non-English speaking, and non-native residents.Washington County:County Administration:Agency Name:Washington CountyDirector’s Name:Tom AdkinsAddress:14949 62nd Street N., Stillwater, MN 55082Telephone Number651-430-6455FAX Number:651-430-6636County Agency Contacts:Area of ResponsibilityNameTitleTelephone Number/Email AddressSocial ServicesKathy MickelsonDivision Manager651-430-6532Health Care EligibilityGeorge StoneDivision Manager651-430-6472Public HealthJill TimmDivision Manager651-275-7286Mental Health - AdultKathy MickelsonDivision Manager651-430-6532Mental Health - ChildrenSarah AmundsonDivision Manager651-430-6597Substance Use DisorderKathy MickelsonDivision Manager651-430-6532TransportationSarah TrippleDivision Manager651-430-6480General County Service Delivery and AccessThe population in Washington County is expected to increase by 36% and almost 100,000 people, by 2040. Over the past decade, the proportion of Washington County’s older population, as well as its ethnic and immigrant populations, has grown at a faster pace than the rest of the state. These growing populations will continue to exert pressure on health care resources, leading to a greater demand for culturally specific services and services for the aging.There is a lack of adequate public transportation in Washington County, presenting significant challenges for low income individuals and those with disabilities. Transit Link is available to all residents during limited times and Metro Mobility operates in only 50% of the county for those eligible for that level of service. Because of this, it is important that MCO(s)/participating entities provide accessible, reliable and flexible transportation options for MA/MinnesotaCare munity-based nursing services are not covered or supported by all of our existing MCO(s) and are an important service to meet the needs of those who are over age 65, have a disability, and/or have special needs. In-home nursing services are a better fit for individuals that struggle with compliance or are civilly committed and court ordered to take medication.Some necessary dental services are not covered and there is a lack of providers. Individuals need to travel out of the county to get dental care due to limited providers within the county. This leads to challenges maintaining routine and preventative care, and difficulties attending to acute problems. Necessary services, such as anesthesia, are not a covered benefit. Children’s Dental Services has a favorable access model, providing services to children and pregnant women in local schools and Head Start centers, and are currently helping fill a gap in Newport and Cottage Grove in the southern part of the county, Forest Lake in the northern part of the county, and expanding to Stillwater in 2015. Access to out-patient psychiatry is very limited in the county, and there are no psychiatric hospitals or residential treatment facilities. The county is also lacking supportive services to meet the needs of youth with mental health issues. Individuals must access psychiatric care in the greater metro area due to the lack of options within the county. Attracting and retaining psychiatric providers and services at an appropriate reimbursement rate to deal with high need SPMI individuals is an existing service gap that needs to be filled. A lack of adequate services to meet the need of those who are SPMI, leads to costly alternatives such as emergency room visits. Finally, many individuals currently being served through adult mental health case management services find the “Silver Sneakers” program a very attractive and valuable feature offered by their health plan.Substance Use Disorder: Continuity of care in Chemical Dependency (CD) treatment is difficult when individuals drop off a managed care program prior to completing their treatment episode. There is often a lack of coordination or care continuity, including limited treatment data-sharing between MCOs and CCDTF. Detoxification services are covered only when inpatient hospitalization is medically necessary because of conditions resulting from withdraw or conditions occurring in addition to withdraw. There is also a lack of adequate transportation surrounding outpatient and/or chemical health treatment and aftercare. Public Health: Most families served via the Public Health Home Visiting Program also have a primary care provider who is in tune with the family and their ongoing health care needs. Despite this, consistent primary care is often lacking for the families served. Utilization of monthly immunization clinics offered through Public Health is down; but overall immunization rates are also low, indicating a gap that is not yet fully understood. ................
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