Jason Hake, the acting executive director of Northcentral Healthcare, gave the committee a broad operational and financial update and answered questions about staffing and legislative risks.

Hake said he stepped into the role in September and described his background in county government and health-care finance. "I have stepped into that role in September," he told the committee. He said Northcentral is a county-operated hospital and skilled-nursing provider that has aligned behavioral-health services with counties and now holds contracts with 32 other counties for inpatient services. In 2025 the organization added two full-time child psychiatrists, including a physician who trained through the Medical College of Wisconsin partnership.

Hake highlighted recognition for the system's work with children and families: staff accepted an award from the Wisconsin Children's System of Care program after being one of 19 nominees statewide. He also described Mountain View, the nursing facility, as having increased rates and census after leadership and operational changes that improved compliance and quality.

On finances, Hake said Northcentral's cash position has strengthened considerably. "We have about a hundred and 25 days, cash on hand. So we went from, you know, a couple million dollars to to having, about $32,000,000 in cash," he said. Hake said that centralizing procurement, compliance, quality and learning functions has produced efficiencies and that employee referrals as a recruitment tool rose from about 7% in 2024 to about 31% in 2025.

Hake also outlined ongoing challenges: competition for staff with other counties and health-care employers; rising health-insurance costs; effects from recently enacted legislation (referred to in the meeting as the "big, beautiful bill") whose financial impact is still uncertain; and telehealth reimbursement changes that expired Oct. 1. He said the organization is planning a 2026 strategic plan to align services across the three counties it serves and to manage debt and capital needs while limiting levy impacts. Hake said the organization had to cover an additional roughly $0.5 million in debt repayment, bringing related obligations to about $4.1 million in the near term.

In response to questions from Supervisor Marash about reported staff terminations, Hake said he could not discuss individual employment matters. On certified nursing assistant staffing, Hake said levels "ebb and flow" seasonally and that Northcentral has been using more agency staff to cover open shifts and to reduce stress on existing employees.

County leadership urged continued prudent planning. Committee members emphasized the need to designate funds for future IT and capital needs, maintain cash reserves given legislative uncertainty, and coordinate with Northcentral's executive committee on longer-term debt and capital planning. Hake said Northcentral and county leaders continue to monitor state and federal developments and participate in advocacy through groups such as the Wisconsin Counties Association and hospital associations.