PHHS investigations concluded, administrator shares findings

The Cook County Public Health and Human Services (PHHS) Board met on Sept. 16 and received a presentation from administrator Kristen Trebil-Halbersma outlining some of the findings of the recent PHHS investigations.

The county first acknowledged the investigations in August, when several PHHS employees resigned and one was terminated.

This was the first time that the findings have been addressed directly at a public meeting, and Trebil-Halbersma told the board that the investigations identified four broad categories of problems within the department. The four areas she listed were policies and procedures, including data protection, revenue and expenses, client services, and work conditions.

Though Trebil-Halbersma was able to speak to WTIP about the investigations, she was unable to give specifics about the testimonies or some of the findings, which included personal data that is protected by state law. WTIP was able to obtain documents outlining the findings, but they were heavily redacted and did not include any pages recounting testimony collected during the investigations.

In the documents, no specific staff are named, either as complainants or subjects of the investigation, outside of former former PHHS Director Alison McIntyre and John Spieker from his role as Behavioral Health Services and Clinical Manager.

Trebil-Halbersma told WTIP that the county is “trying to share as much information as we can,” but that they are limited in what can be made available to the public while still complying with state law. She was able to talk generally about the concerns raised by the investigations and what the county is planning moving forward.

Client Services

Through PHHS, county residents are able to access a wide variety of services, ranging from financial services to those aimed at addressing behavior health needs, to services for youth and families. Specific details in the investigations’ findings related to client services contained very little public information, beyond phrases that pointed to services in social work, including those for minors in out-of-home placements.

“Some of the things that that we found as a result of the investigation,” Trebil-Halbersma said, “Is just needing to ensure that we have the correct policies and procedures in place to provide the expectations to staff, so that we can ensure that that we’re providing the best quality services for our clients.”

The county recently contracted with two consultants, who Trebil-Halbersma said she hopes will be part of the process of improving client services. One of those consultants, David Lee, is a behavioral health clinician and will be providing supervision to the behavior health staff as the county works to fill the supervisor vacancy which followed John Spieker’s resignation from that role in August. Trebil-Halbersma said “We’re focusing on our family and children services space, because that’s where we have vacancies at this time, and where we feel is the most important place to focus our time and attention, given the findings in the investigation, as well as the staffing shortages.”

In addition to the client services concerns raised by the investigation, Trebil-Halbersma also spoke about the performance improvement plan issued by the Minnesota Department of Human Services (DHS) targeting problems in how cases that fall under the Indian Child Welfare Act (ICWA) were being handled. She said, “We’re working with DHS and with a team, as well as representatives from Grand Portage, to put that plan in place as we move forward.”

Revenue and Expenses

The investigations found some administrative issues within the department, including irregularities in how staff recorded their time for billing purposes. A large portion of the revenue PHHS generates is through tracking time and services in order to access funds from the state to cover expenses. The findings documents stated, “In 2023, the department was 303% of budget on expenses and 64% on revenue. In 2024, the department was 199% of budget on expenses and 34% on revenue.”

The failure to adequately report services meant the department missing out on state funds through Targeted Case Management (TCM) income, which the documents described as a “significant revenue source for the PHHS.”

During the PHHS meeting, Trebil-Halbersma made a distinction between these department finance issues and the work of financial reporting staff in the department. She told WTIP, “I want to make sure that it’s clear that our economic assistance group, our financial reporting group, are very strong, and that this was not due to a lack of the work that they’re providing. The issues that we experience within revenue and expenditures, our expenses, was more of a lack of outlining the necessary expectations and tracking, and monitoring compliance with expectations at the leadership level.”

While presenting this information to the PHHS board, Trebil-Halbersma and Interim Director Plamen Dimitrov spoke about the need to provide better oversight from a management level to ensure that case workers are reporting their time and work correctly. This could include additional training for staff.

While the results of the investigation have only newly been released, the financial problems were years in the making, and concerns around the service tracking issues were raised internally, according to the findings documents. Trebil-Halbersma added, “I believe that concerns and issues had been brought to leadership in the past. I can’t speak to the level of engagement in those discussions with leadership, but it was identified as something that we need to improve as we move forward”

Work conditions

The findings documents identified a series of problems related to working conditions within PHHS. This included both staff dissatisfaction with the work atmosphere, and their concerns over leadership, supervision, and adequate training. Trebil-Halbersma said one of the issues was the responsiveness of those in leadership roles in addressing staff concerns when they were raised.

“I think everyone within our team is very committed to ensuring that we have a very solid work environment, an inclusive and supportive work environment for our staff within the department. And so we want to make sure that we’re hearing from staff,” Trebil-Halbersma said. “So when I think about, you know, supporting the team, it’s at that highest level, but also the day to day work that they do, ensuring that they have the resources to be successful in the services that they provide to the community.”

Oversight

A theme in the problems uncovered by the investigations is issues with oversight and enforcement of policies and best practices. In a county department like PHHS, there is some division in the creation and enforcement of policies. Generally, the role of the board is to craft policies, and then it is the role of the director and supervisors to ensure compliance.

In addition to the shift in working conditions and supervision, Trebil-Halbersma said that as policies change or the department structure is adjusted, she aims to keep the PHHS board more engaged in the process.

Trebil-Halbersma’s presentation at the PHHS meeting included information that was likely new to most members of the public. Until now, the county has not spoken about the subject matter of the investigations. This included with county employees and elected officials who were not involved with the investigation.

Trebil-Halbersma explained, “During the investigative process, much of the investigation was confidential, and so we were not able to share information even with the commissioners related to what was happening. Once the investigations closed, they had access to the investigative reports, and so coming into the board meeting today, the commissioners, if they chose to review that information, had access to review that information.”

Trebil-Halbersma was unable to confirm whether any of the commissioners had requested to see the non-redacted reports, saying those requests were handled by the county attorney’s office. Attorney Jeanne Peterson did not respond to WTIP’s request for comment on this question.

WTIP requested comment from former Administrator James Joerke on whether the problems identified by the investigations were known to him during his time with the county.  Joerke responded, saying, “I am confident that the county has been as transparent as it can be without divulging private information and have nothing to add.”

Further changes

The county is working to fill the PHHS director role, which Dimitrov said at the PHHS meeting he would not be applying for. Along with the change in leadership, Trebil-Halbersma said they are continuing to consider restructuring within the department. The second consultant the county has contracted with, Meghan Mohs of Birch Bark Consulting, LLC, specializes in working with public health and human services departments and was hired to assist with assessing the functionality of the department. Trebil-Halbersma herself also has a background in organizational management and structuring.

With the general findings of the investigations now public information, the county is continuing to work toward resolving the problems identified. Trebil Halbersma said, “Now that we’re post investigation, our focus is certainly on ensuring that we are rebuilding in terms of filling the positions that we have vacant, doing an overall assessment to make sure that we’re identifying any areas where we need to improve best practices. We will be focused on compliance as we move forward as well.”

During this time of transition, the department continues to grapple with short staffing. Trebil-Halbersma commended the PHHS employees who have worked to maintain services during this time, and acknowledged Dimitrov for his efforts.  She said, “I can’t thank [Plamen] enough for the work that he’s done, and again, for the staff that have been so committed to ensuring that we’re continuing to meet the community’s needs.”

WTIP’s Kirsten Wisniewski spoke with Administrator Kristen Trebil-Halbersma. Audio of that interview is below.

This article was updated to reflect documents made available by the county that had less redaction, naming both Alison McIntyre and John Spieker.

Kirsten Wisniewski September 19, 2025