Cook County PHHS director presents 2024 year‑end report: staffing turnover, caseload growth and program expansions

Allison McIntyre, director of the Cook County Public Health and Human Services Department, presented a year‑end review for 2024 at the board’s Jan. 21 meeting that documented staff turnover, growing caseloads and several program expansions funded in part by state grants.

McIntyre told commissioners the department experienced 11 position turnovers in 2024, including six resignations and five internal promotions or transfers. Staff accumulated 2,047 hours of overtime or comp time in 2024, with a reported dollar value of $86,000; McIntyre said just over $33,000 of that total was overtime paid out during the year and roughly $53,000 represented comp time or paid leave paid out when employees left the organization. Two positions — the coordinated crisis response worker and a children’s mental health case manager — had long vacancies during 2023–24 and were recently filled or re-advertised.

McIntyre summarized caseload and intake trends: unduplicated clients in social services rose from 365 in 2019 to 647 in 2024 (491 adults and 156 children in 2024). Intakes increased from 318 in 2019 to 509 in 2024; in 2024 intake counts included 40 adult mental‑health intakes, 42 adult protective services, 167 general adult services, 42 substance‑use disorder intakes, 120 child protection and 44 child welfare. McIntyre said the increase in children served represents a 152% change from 62 unduplicated child clients in 2019 to 156 in 2024.

On behavioral health and substance use, McIntyre reported the department contracted with licensed counselor Greg Barnier for clinical services in the county’s state‑licensed wilderness outpatient treatment program. The county scheduled 80 comprehensive substance‑use disorder assessment appointments in 2024; 28 were canceled, 52 assessments were completed and 32 people received treatment coordination services through the department’s substance‑use disorder and co‑occurring disorders case manager.

Program development highlights in 2024 included state‑funded additions and pilots: the department added a health educator position fully funded by a state grant to lead youth substance misuse and suicide prevention work and hired a youth prevention specialist, Rocio Rivas, to convene a Young Adult Life Leaders cohort. The department received state certification to operate as a certified mobile crisis response provider and began implementing an electronic health record as the record of service for mobile crisis and substance use programs. Public‑health grants supported a three‑year Healthy Homes in‑home assessment program, a home‑envelope pilot with the county housing agency, a well‑water testing program, a child‑care wage enhancement pilot and a transit purchase through the Boreal Partners project to provide an accessible vehicle.

McIntyre noted the department issued a competitive subgrant round and recommended $190,000 for local nonprofit projects tied to the county community health priorities. She also described outreach activities including monthly articles in the County News Herald and regular radio interviews.

On revenue and funding, McIntyre said the children and family services case manager generates state revenue through targeted case‑management reporting but is “less than 50%” reimbursed; economic assistance and health‑care program staff are reimbursed at roughly a 50% rate. McIntyre warned the board that the governor’s recently released budget proposal shifts costs to counties for some human‑services programs in the 2026–27 biennium and encouraged commissioners to follow Association of Minnesota Counties updates.

McIntyre closed by reminding commissioners how to connect constituents to department services and saying staff would return the missing donations letter in the February packet.

Board members asked for more detail on revenue percentages and for links to earlier presentations that documented historical caseload and billing trends; McIntyre agreed to provide that material.