MARATHON COUNTY — Jason Hake, acting executive director of Northcentral Healthcare, told the Marathon County Health and Human Services Committee that the county-run health system has made significant operational and financial gains but still faces workforce pressures and uncertainty from recent state policy changes.

Hake said Northcentral has strengthened both its behavioral health services and its long-term care operations. He highlighted that the system now holds about 125 days of cash on hand — which he estimated at roughly $32 million — and has increased inpatient census and contracts with 32 other counties that use Northcentral’s services. In 2025 the organization added two full-time child psychiatrists and was one of 19 nominees recognized by the Wisconsin Children’s System of Care for work serving children, young adults and families.

"We have about a hundred and 25 days cash on hand," Hake said, recounting the organization’s turnaround and attributing it to higher census and Medicaid rate increases. He described several internal changes that management has pursued, including centralizing procurement, compliance, quality, and learning and development to create efficiencies and consistent practice across programs.

Hake also described ongoing challenges. Recruitment and retention remain a concern; the organization’s employee referral hires rose from about 7% to 31% year over year, but certified nursing assistant (CNA) staffing is seasonal and has required more use of agency staff to cover open shifts. Hake said leadership changes in Mountain View’s nursing administration and director-of-nursing roles have occurred; he declined to discuss individual employment matters when asked by Supervisor Marash.

Committee members and executive committee representatives urged caution about using reserves. A county official noted that while increased reserves are positive, the funds should be prudently designated for upcoming capital and IT needs and to cover future debt-service obligations. Hake said the organization is planning a strategic plan for 2026 focused on quality, financial sustainability and alignment with the three counties it serves.

On policy risk, Hake cautioned that pending state actions (referred to in the meeting as the "Big Beautiful Bill") and expired telehealth extensions could affect payer coverage and increase uncompensated care. He said state guidance may arrive in mid-2026, with material impacts more likely to appear in 2027, and emphasized the need to maintain cash reserves while the system monitors state-level developments and participates in advocacy.

Hake said the organization limited tax levy requests to the three member counties this year and that debt-service obligations necessitated an additional roughly $500,000 this year, bringing related county levy support to about $4.1 million. He and county leaders said they will continue to plan for capital projects, including IT system upgrades, and review cash-on-hand targets to ensure readiness for future lean periods.

The committee did not take formal action on the update; members asked Hake and Northcentral leadership to continue coordination with county staff on fiscal planning.