Fillmore County officials were left with questions and at least one major concern after they heard a report on the redesign in offering human services throughout a 12-county area of southeastern Minnesota.

Mark Howard of Accenture, a consulting firm doing the study and projects, presented a PowerPoint slide show and answered questions at the March 27 Fillmore County Board meeting. Attendees included the county commissioners, Community Service heads and lead persons and newly hired Community Services director Beth Wilms, who will work with Fillmore County through a contract with Winona County.

Commissioner Chuck Amunrud, who worked prominently in the groups forming the redesign study, could not be present in person, but listened in and spoke by conference phone.

The idea behind redesign is to provide better services at a lower cost with better outcomes through a collaboration. Howard ran through the premises being discussed. He said it was time to bring the county boards and chief financial officers in "to dive into the business model."

When all was said and done, it was noted it's tough to work out sharing expenses between one very large county, others that are mid-sized and a number of the 12 that are small. Olmsted County would fall in the first category, while Fillmore County falls in the last.

Howard said $50 million is now spent in county dollars. It would take three years to transition into the new program.

Howard said funding formula considerations currently call for using the ability to pay (given as a percentage - and expressed as tax capacity) and also the demand for human services (given as a percentage - and expressed as population).

Howard said most models showed estimated savings (also noted as "cost avoidance") of $25 to $40 million... "most get us around $30 million."

Commissioner Duane Bakke said he'd seen the preliminary numbers. He noted most of the money savings went to Olmsted. He and other commissioners noted Fillmore County has managed its human services very effectively and at a very reasonable rate.

Using this formula, Howard had a draft chart of projected "cost avoidance" that showed Olmsted County would save $21,373,764 in five years. Fillmore County would save $156,999, which ranked 11th of the 12 counties. Also notable, in the fifth year of the program, Fillmore County would spend $35,023, as opposed to saving money. Five other counties with what appears to be well-managed human services programs also would need to spend money in the fifth year.

Howard said of this formula and others looked at, "every opportunity we had given had winners and losers." He further noted of the above information, "In five years you would spend $35,000 more than is staying separate." Also, he said there would be a wide, better range of human services.

"But this is where we're at. Now we need to start the conversation," stated Howard.

Amunrud asked on the phone if any scenarios were based on caseloads. Howard said the counties spending less have a higher caseload per worker, while the opposite also holds true. He thought caseloads would even out over the counties.

"Would this work without Olmsted County?" was asked.

Howard said it would, but it would look very different. He also noted the current scenario "has far more services than Fillmore County is offering today."

He stressed the work was not at a decision point right now, but should occur by May 1. The three big questions are, he stated, "How will it be governed? What will the costs be for the organization/district across 12 counties? And how do we pay for the transition to that?"

Other business

• Beth Wilms was introduced as the new Community Services manager. She is contracted through Winona County. She plans to spend at least one day a week in Fillmore County. Her salary through the end of 2012 will be $3,515.37 per month, billed on a quarterly basis. Wilms said she'd worked with Houston County for 10 years. She was looking forward to working with the redesign process, calling it "cutting edge." Her office will be in the Fillmore County Office Building, in the Public Health office.

• The commissioners signed a resolution in support of changes to the Duschee Hill/Inspiration Point on Highway 16. The county is following the lead of Lanesboro in seeking a change in the highway following many traffic accidents at the site.

• Dr. Lindsey Thomas, the county's medical examiner with Regina Medical Center in Hastings, presented information on a projected move into the Hennepin County medical examiner's stand-alone facility in Minneapolis.