County and state officials meeting to discuss emergency management

By Robert Williams

Editor

Otter Tail County Assistant Public Health Director Kristi Goos and Partnership 4 Health Dental Services Coordinator Jane Neubauer updated the Otter Tail Board of Commissioners on the Dental Innovations Program on Tuesday, Feb. 24 in Fergus Falls.

According to Goos, the program began at a statewide conference eight years ago with Blue Cross Blue Shield (BCBS) leadership. Since that time, grant funding from BCBS has been provided to seven regions across the state. The funding also created Neubauer’s position.

Neubauer provided an overview of the program.

“There is a huge need in our region and Otter Tail County, specific for oral health care for people of all ages,” said Neubauer.

The program began in 2010 when Apple Tree Dental opened in Fergus Falls. Apple Tree is the same company that once planned to build a dental center in Frazee but pulled out of the plan in November of 2023.

In 2012, mobile dental clinics were established in Pelican Rapids School and New York Mills County Office Building, but the program stalled until a BCBS grant in 2020 brought it back.

Mobile clinics were added at Head Start Center in Perham in 2022 and Henning in 2023. The expansion created mobile services in Parkers Prairie and Battle Lake in 2024. Last year, a commitment for mobile dental services was added at Underwood.

“At the beginning of next school year, we will have some sort of dental care option in all of our school districts in the county, so that’s pretty exciting,” said Neubauer.

Mobile dental services are provided to all the schools in the county making two visits per school year to each district from one of three providers. There are also sliding fee scale programs for uninsured students to be seen at a reduced rate.

“It’s one of the things we struggle with because there are kids and people out there that don’t have any insurance,” Neubauer said.

There was also an update on Apple Tree Dental’s work in Becker County.

According to Neubauer’s report, Apple Tree Dental began providing expanded access dental care in partnership with Essentia Health in Detroit Lakes at their temporary location on September 5, 2024. 

Highlights of the project include:

• Nearly $1M secured in local, regional and state funding to support expanded dental services through Apple Tree Dental in Detroit Lakes.

• Over $3.4M secured in grant funding to expand Apple Tree Dental Hawley’s clinic from 8 operatories to 14 operatories. The Apple Tree Hawley Center also supports and serves as the hub for the expanded care in Detroit Lakes.

• New dental equipment has been purchased to outfit 3 dental operatories in Detroit Lakes.

• Apple Tree is currently scheduling two preventive days per week in Detroit Lakes and will increase this time as scheduling and hiring of additional dental professionals allow.

• As of December 31, 2024, Apple Tree Dental-Detroit Lakes has completed:

º 400 hygiene visits

º 35 restorative visits

• Apple Tree Dental Detroit Lakes is currently on track to exceed the required 772 visits by the end of May 2025, per the Minnesota Department of Health grant objective.

The planning committee is continuing to explore multiple locations in Detroit Lakes to identify a full-time permanent location for the Apple Tree Dental Detroit Lakes Clinic. A second tour of one facility is scheduled for this week.

Plans are to lease for three years before expanding upon plans to build a new building in DL.

Future initiatives involve retaining Neubauer’s position, along with expanding dental access to seniors.

BCBS has pulled back on some grant funding and had stated they were going to stop funding two years ago. They found funding to continue the program. According to Goos, there is funding to get through the first half of 2026 to continue the Becker County work. Other avenues are being pursued for continued funding, including talks with the Minnesota Department of Health and Minnesota Oral Health Coalition and other larger stakeholders. Seven regions are doing this type of work so funding is being pursued by at least that many entities.

Emergency Management

Emergency Management Director Patrick Waletzko provided information on an annual grant agreement with the Minnesota Department of Public Safety for reimbursement of activities done related to emergency preparedness and management in 2023.

“The state is slowly catching up in terms of processing grants and giving money back to us,” said Waletzko.

This is a federal grant that the state receives and then the stated emergency management agency passes on 51 percent to counties, tribes and cities of the first class, according to Waletzko.

The number one use of the funds goes to the Smart 911 emergency notification system. The average amount each year is $37,651.

Highway

Commissioners authorized county officials to sign a professional services agreement for design engineering services for the road project CSAH 8 from Hwy. 10 to CSAH 80 (Main St.) in Perham with SRF Consulting Group, Inc. in an amount up to $103,546.50.

Otter Tail County received eight competitive proposals for this project. A team of three independently rated the qualifications, experience and project management capabilities of each firm/team, and the department recommended SRF Consulting Group, Inc. lead this project in cooperation with Otter Tail County and the city.

Additional field work is needed to confirm the pavement design options for this project.

Commissioners authorized county officials to sign Braun lntertec’s amendment to the project in the amount of $5,720 for a revised contract total up to $14,648.00.

Braun lntertec’s contract was previously approved on April 23, 2024. 

Legislative

The board approved a Scott County letter of support for reducing the frequency of MnChoices assessments.

The board agreed to full support for amending federal requirements to reduce the frequency of HCBS reevaluations. The board proposed reducing the frequency to once every three years, upon request, or when there is a significant change in a person’s condition or need. This policy change will allow counties to allocate resources more effectively, including the workforce for completing evaluations, and—most importantly—ensure that people can access essential HCBS without delay.

Families in Otter Tail County and across Minnesota are experiencing wait times and delays in accessing needed services. This policy change is critical to serve older adults and people with disabilities effectively.

A MnCHOICES assessment is a free, in-person evaluation that helps people determine their eligibility for community-based services. It can also help people choose support services and develop a care plan.

Deputy Administrator Nick Leonard introduced community services recommendations for 2025 to the state legislature:

• Support legislation that preserves resource recovery as the best available technology in lieu of landfilling in accordance with the waste management hierarchy.

• Oppose budget deficit solutions that shift costs to Minnesota’s counties, raising property taxes and disproportionately impacting low-income residents.

• Support changes to the PFMLA and ESST laws that provide additional employer clarifications, and rectify inconsistencies and logistical oversights in the laws.

• Expand access to state operated mental health beds.

• Support strategic investments in a comprehensive emergency response system that ensures equitable access to 24/7 ambulance services.

• Support initiatives to address gaps in the mental health continuum for youth in the justice system including increased early intervention, long-term treatment, housing, and support.

• Enact a bonding bill that includes local transportation programs. Fund the Local Road Wetland Replacement Program. Sustain Highway User Tax Distribution Fund Revenues. Fully fund the County Local AIS Prevention Aid program. Support LCCMR Bill.

Otter Tail County is in a unique position to develop and pilot solutions to Minnesota’s rural emergency medical service crisis. OTC is the seventh largest county with a year-round population of over 60,000 that nearly doubles during the summer months.

The county has a significantly older median age than the state and a larger percentage of people aged 65 years and older

There are seven ambulance services, comprised of four different models – private, city department, joint powers and hospital-based. Ambulance services are losing $181 per call on average.

“The challenge facing EMS is that as our costs have increased, reimbursement has not changed or not kept up. EMS is also more frequently used for community services that are not reimbursable through insurance, and usually go unpaid,” said Becca Huebsch, Director of Emergency Medical Services and Emergency Preparedness for Perham Health in the report. “This trend has not surprised people that have been paying attention, but now it’s really coming to a breaking point where systems have been underpaid for so long, they’ve used up their cash reserves and have to put off big purchases. Every time the pager goes off and we respond to an emergency, we’re digging ourselves deeper into a hole.”

EMS staffing is also a concern.

“Rural ambulance services are in a crisis because of a shortage of workers. Last year, the city dropped its requirement that some city workers help drive the ambulance, as it was difficult for them to respond,” Beth Wussow, Administrator of the City of Parkers Prairie said in the report. “For a while, the crew dropped to five or six—far less than the 15 or more that we need to have on staff. When we were short-handed, those five or six people handled all the calls. They never missed one, but it was exhausting.”

OTC Board Chairman Wayne Johnson also acknowledged the problem of wait times.

“Your healthcare shouldn’t be determined by your ZIP code,” he said. “I spoke to a local law enforcement officer who performed CPR on a person for over 45 minutes waiting for an ambulance to arrive. We have 1,500 unfilled jobs in Otter Tail County. We promote our county as a great place to visit, live and work. But frankly, who would want to move to a community knowing that they can get a pizza delivery faster than an ambulance. When someone dials 911, regardless of where they live, they should have confidence that emergency services are on the way.”

District 4 Commissioner Robert Lahman had some terse words on government funding.

“You never know what the federal government is going to do,” Lahman said. “We’ve already, at Mahube-Otwa, have seen a hold on our funds for early childhood. We were unable to pay our teachers for a couple of days. I think we have to keep that in mind in all this.”